Publications (Medicaid) « Medicaid

Publications About
Medicaid

• A Guide to the Medicaid Appeals Process (Kaiser Foundation) 
  This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance.
   
• Access to Long-Term Services and Supports: A 50 State Survey of Medicaid Financial Eligibility Standards (AARP – 2010) 
  This report provides a long-awaited update to existing data on Medicaid financial eligibility standards adopted by each state for older persons and adults with disailities.  These standards serve as an important measure of access to Medicaid long-term services and supports in individual states.  The report contains detailed information on Medicaid eligibility in all 50 states and the District of Columbia.
   
• Advocate's Guide: Medicaid Long Term Services and Supports 101: Emerging Opportunities and Challenges (National Senior Citizens Law Center) 
  In passing the Patient Protections and Affordable Care Act (ACA) in 2010, Congress took arguably its most aggressive action toward rebalancing Medicaid long term services and supports (LTSS) spending in nearly three decades. However, since then, many states under budget pressure have put many Medicaid home and community-based care programs (HCBS) at risk. This new guide offers advocates a primer on the law that impacts Medicaid-funded HCBS. It also explains the different programs states can use to provide HCBS, including those created by the ACA. The guide highlights key resources and tools to use when advocating to expand and preserve Medicaid coverage of crucial LTSS services in individual states.
   
• Briefing Document on Section 1915(c) Medicaid Waiver Service Definitions (Aging and Disability in America – 1/2/11) 
  Service definitions that focus on employment outcomes are an important component in communicating expectations and building system capacity to increase opportunities for people receiving Home and Community Based Services (HCBS) to participate in the general workforce.
   
• CMS Should Take Additional Steps to Improve Assessments of Individuals’ Needs for Home- and Community-Based Services (December 2017)  
  Highlights of GAO-18-103, a report to congressional requesters. GAO was asked to examine states’ needs assessment processes for provision of long-term services and supports. This report addresses (1) how selected states assess needs for HCBS, and (2) steps CMS has taken to improve coordination and effectiveness of needs assessments, among other objectives. GAO studied six states that varied in terms of assessment tools in use, participation in federal initiatives, HCBS delivery systems, and geographic location; reviewed federal requirements and documents; and interviewed CMS officials and stakeholders.  
   
• Determining Income When Applying for Medicaid (Ronald Fatoullah & Associates) 
  When reviewing an applicant’s income, the Medicaid caseworker will consider the amount and the type of available income. Income can come from any source.

• Families Tell Their Stories About Medicaid (NAELA) 
  Elder Law Attorney Helps Family Navigate Complicated and Confusing Medicaid Regulations
   
• Looking Ahead – Estate and Long -Term Planning for You and Your Family (Kenneth M. Coughlin & Harry S. Margolis) 
  Looking Ahead explains the key components of estate and long-term care planning. The book serves as a guide both for doing prudent planning before a future need arises and for dealing with a life event that is looming, generally the need for long-term care. The basic rules of Medicaid planning are explained.
   
• Major Changes in Both Medicaid and Medicare Affecting Your Clients (Sanford J. Mall, JD, CELA – Summer. 2007) 
  Recap of changes in law and policy that vastly affect basic health care, catastrophic medical, rehabilitation and long-term care for elders and persons with disabilities.
   
• Making Connections: Medicaid, CHIP and Title V Working Together on State Medical Home Initiatives (Nat'l Academy for State Health Policy) 
  The medical home model–an approach to offering excellent primary care–is gaining momentum. A wide range of stakeholders are now embracing medical homes, and the Affordable Care Act has dedicated resources to developing and spreading the model. In this context, states have been leaders in building medical homes – especially for vulnerable populations.   
   
• Medicare and Medicaid Basics  (CMS.gov – MLN booklet) 
   
• Medicaid Managed Long-Term Services and Supports Programs: State Update (CHCS – June 2017) 
  Medicaid is the nation’s largest payer of long-term services and supports (LTSS), funding these services for nearly five million Americans. An increasing number of state Medicaid agencies — 22 as of July 2017 — are providing LTSS through capitated contracts with managed care organizations, with roughly 1.2 million individuals enrolled in comprehensive managed care plans that include LTSS or managed LTSS-only plans. 
   
• Medicaid Pocket Primer – Fact Sheet (Kaiser Family Foundation – June 2017)
   
• NHeLP's Protect Medicaid Webinar Series (NHelp) 
  Proposals to drastically cut federal Medicaid spending through per capita caps and block grants would fundamentally alter and undermine Medicaid. NHeLP's Protect Medicaid webinar series examines the harmful impact of these proposals on key features of the Medicaid program, including: services and benefits geared for vulnerable populations; affordability and cost sharing protections; advances under the ACA's low income adult expansion; and consumer protections and due process guarantees.
   
• Protecting the Rights of Low Income Older Adults (NSCLC) 
  With support from the Commonwealth Fund, the National Senior Citizens Law Center undertook an extensive study of federal and state Medicaid policies for assisted living coverage – with a special focus on how such policies impact the lives of low-income older adults. 
   
• Report to the President and Congress: The Money Follows the Person (MFP) Rebalancing Demonstration (June, 2017, Department of Health and Human Services)
  Evaluation and report on spending, cost reduction, and transition of individuals as required by the Deficit Reduction Act of 2005 and Affordable Care Act of 2010.
   
• The Faces of Medicaid III: Refining the Portrait of People with Multiple Chronic Conditions (CHCS – 10/09) 
  Latest issue in the Faces of Medicaid series. Each iteration has brought warranted attention to the complexity of Medicaid's high-need, high-cost populations and the challenges inherent in designing cost-effective systems of care for them. 
   
• Using Medicaid to Finance and Deliver Services in Supportive Housing (National Council for Behavorial Health) 
  This paper discusses the policy context driving the inclusion of more integrated permanent supportive housing (PSH) options within state and local behavioral health authorities, and builds on recent federal guidance regarding Medicaid reimbursement for housing-related services. State behavioral health authorities, Medicaid agencies and organizations serving people with MI and/or SUD each play a critical role working together to identify, pay for, and implement these types of services.