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Tags Posts tagged with "Medicaid"

Medicaid

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Hole torn in a dollar bill with medicaid text

Deputy Secretary Ahrens has shared information regarding avoidable Medicaid non-renewals for individuals. If an individual is receiving waiver services and loses their MA, this has the unfortunate outcome of the individual being dis-enrolled in the waiver. In turn, services rendered during a time when the individual is ineligible will not be paid through waiver funds.

If your agency serves as a representative payee or provides waiver services, especially residential services, this can have a serious impact on both your agency and the individual receiving services. Of note:

  • As of 10/17/2023, the Office of Developmental Programs (ODP) has a record of 444 enrolled individuals (223 of whom are waiver participants) whose MA was not renewed procedurally. These participants’ renewal dates span April through September 2023.
  • 176 individuals (45 of whom are waiver participants) were registered and had their MA closed due to ineligibility.

The primary reasons appear to be that asset limits were exceeded and determination paperwork had not been returned (procedural closure). There are individuals who receive residential services in these groups. Please note that sometimes paperwork may go to a guardian or representative payee. In those situations, it’s important that there is communication between the provider and the responsible person. In particular, providers should be aware of the following:

  • Individuals receive MA renewal paperwork in the mail at their home address. Providers/SCOs should ensure that the CAO always has up-to-date contact information for individuals receiving MA.
  • Renewal dates differ. Individuals should receive renewal info about 90 days prior to the due date.
  • If a provider has questions about renewal dates for individuals, AEs and SCOs are provided data on all individual MA renewal dates.

Please ensure that your agency is aware of the renewal dates and is prepared to respond quickly and/or assist the guardian or family member who may be receiving the paperwork. Additionally, please be cognizant of the asset limits and consider opening an ABLE account if all the individual’s needs are met.

For any questions, contact Carol Ferenz.

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The goal of DRMA is to ensure access to Medicaid/CHIP assistance for survivors of major disasters and public health emergencies who have to evacuate across state lines.

Along Senator Casey (PA) Co-Sponsors in the Senate are: Blumenthal (CT), Welch (VT), Van Hollen (MD), Gillibrand (NY), Warren (MA), Brown (OH), Sanders (VT), Fetterman (PA), Schatz (HI), and Duckworth (IL).

Along Congressman Panetta (CA) and Takano (CA), Co-Sponsors in the House are: Tokuda (HI), Crockett (TX), Blunt Rochester (DE), Holmes Norton (DC), Soto (FL), and Moore (WI).

Read the one-pager on DRMA here.

You can join the hundreds of organizational and individual endorsers.

More than 90 million people nationwide benefit from Medicaid and CHIP, and they’re at risk of losing it when the next disaster strikes! Contact your representatives and ask them to support the Disaster Relief Medicaid Act.

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Pennsylvania Senator Bob Casey, the Chairman of the Special Committee on Aging, will be introducing new legislation on the floor of Senate titled “The Home and Community-Based Services (HCBS) Relief Act of 2023.”

The HCBS Relief Act of 2023 would provide dedicated Medicaid funds to states for two years to stabilize their HCBS service delivery networks, recruit and retain HCBS direct care workers, and meet the long-term service and support needs of people eligible for Medicaid home and community-based services. States would receive a 10-point increase in the federal match (FMAP) for Medicaid for two fiscal years to enhance HCBS. Funds could be used to increase direct care worker pay, provide benefits such as paid family leave or sick leave, and pay for transportation expenses to and from the homes of those being served. The additional funds also can be used to support family caregivers, pay for recruitment and training of additional direct care workers, and pay for technology to facilitate services. The funds can help decrease or eliminate the waiting lists for HCBS in the states.

The HCBS Relief Act of 2023 will be introduced during the fourth week of October with a House companion bill expected to be released in the near future. Please join RCPA in supporting this critical piece of legislation to create a viable and sustainable pathway for HCBS.

If you have any questions, please contact your respective RCPA Policy Director.

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As part of its commitment to advancing health equity and access to care for underserved populations, CMS released a set of resources addressing the needs of adults with intellectual and developmental disabilities (I/DD) living with and cared for by aging parents or guardians. The release includes resources for state Medicaid and partner agencies to provide new or additional support to adults living with I/DD and their caregivers as they age and experience life transitions.

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