SD Network

Category: Medicad

As the start of 2024, many issues are at play that will affect Medicaid coverage, financing, and access. Medicaid is the primary program providing comprehensive health and long-term care coverage to one in five low-income Americans. This article explains what else to watch for in Medicaid coverage in 2024.

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Recently, the White House hosted care leaders, workers, and champions to discuss new data from the Centers for Medicare & Medicaid Services (CMS) on funding for home and community-based care through the American Rescue Plan. These funds are an investment in strengthening access to home and community-based services (HCBS) across the country. All 50 states are using this funding to improve their long-term care systems. 
At the White House event, Health and Human Services Secretary Xavier Becerra announced that the department, through CMS, is providing additional tools that will help improve access for millions who receive Medicaid HCBS. CMS issued new guidance focused on building and maintaining worker registries so more individuals receiving Medicaid-covered services can receive care in a setting of their choice.
This guidance marks another step toward increased access to quality HCBS so older adults and individuals with disabilities can live safely and independently in their homes and communities.
Read more about how these investments in long-term care and the care workforce expand access to care by investing in our direct care workforce. 
Watch the White House event
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The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2022 Report to Congress on Medicaid and CHIP, recommending a series of measures that Congress could take to create a better system for monitoring access to care for Medicaid beneficiaries, improve the oversight and transparency of managed care directed payments, increase access to vaccines for adults enrolled in Medicaid, encourage the uptake of health information technology (IT) in behavioral health, and better integrate care for people who are eligible for both the Medicaid and Medicare programs. In addition, the Commission offers policy levers that states and the federal government can use to promote equity in Medicaid.



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The Survival Coalition is asking you to complete a short, 10 question online survey on how we can make Medicaid better for everyone. As you probably know, Congress was thinking about making big changes to Medicaid in order to save money. Wisconsin Medicaid programs include: Family Care, IRIS, Katie Beckett, Children’s Long Term Care, MAPP, mental health programs, autism services, BadgerCare and services provided by the ForwardHealth Card. We want to know what ideas you have on how to make Medicaid better!
 
Please complete the survey at the link copied here:  https://www.surveymonkey.com/r/WXYMHS7
 
Feel free to share the survey with anyone who also has ideas on how to make Medicaid better. We will use your answers to write a report on new ideas for Medicaid. The last day to complete the survey is Monday, November 6
 
If you have questions about the survey, please contact the Survival Coalition at: survivalcoalitionwi@gmail.com 
 
Thank you for taking the time to complete the survey!
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More than 1,500 people responded to Survival Coalition's survey asking how Wisconsin's disability community uses our state's more than 20 Medicaid programs, and how their lives would be impacted if Medicaid changes (e.g. funding is cut and per capita caps are imposed as passed in the House version of the AHCA). Here is a sampling of those statewide results, organized by Congressional district, along with information about Medicaid and Medicaid funding in Wisconsin.

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On April 25th, The Arc Wisconsin hosted an on-line conversation with The Survival Coalition of Wisconsin Disability Organizations and the Wisconsin Long-Term Care Coalition to update Wisconsin residents on the latest threats to Medicaid. This training featured the latest information direct from The Arc US lobbyists who have been spending time on Capitol Hill.
 
Congress is considering proposals that are estimated to cut federal Medicaid funding by 25%. Wisconsin currently operates more than 20 Medicaid programs; one in five people use some form of Medicaid which can include Birth to 3 services, Family Care, IRIS, school therapies, Katie Beckett, autism supports, personal care, mental health supports and more…
 
You can listen to a recording of the training by going to this link.
 
See the presentation slides: http://www.survivalcoalitionwi.org/wp-content/uploads/2017/05/Next-Steps-for-Advocates-Protecting-Medicaid-4-25-17.pdf

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The process for accessing personal care services through Medicaid is changing for those who are enrolled in “fee for services” Medicaid. This impacts most children and some adults including:

  • BadgerCare Plus members
  • Wisconsin Medicaid members
  • Include, Respect, I Self-Direct (IRIS) members who do not self-direct their personal care services
  • Members enrolled in Wraparound Milwaukee or Children Come First programs

The change impacts the assessment process to determine eligibility and the numbers of hours of support a member is eligible to receive. DHS recently issued a Forward health memo called the  New Personal Care Independent Assessment and Prior Authorization Policy describing the change. Attached is the fact sheet that was sent to members starting Monday April 17th. Implementation will start June 1st.

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Late in March, a proposal to overhaul the nation's healthcare system and revamp Medicaid was voted down.  Advocates feel it's  good news  for people with disabilities.  There were simply not enough votes to pass the legislation.

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George Town University released an article listing the top five threats posed  to  children and families by turning the Medicaid program into a block grant.  The reasons include:

  1. It's a cut.
  2. It jeopardizes the nation's progress in covering kids.
  3. It leaves states holding the bag when a new disease strikes or a new treatment is discovered.
  4. It diminishes state flexibility to respond to changing economic circumstances.
  5. It endangers key features of Medicaid that work for kids – namely its strong benefits and cost-sharing protections.

The article explains why each reason is a threat.  Block grants are said to bring innovation and opportunities to states, but many feel that any major changes to Medicaid would have a big impact on  the health and financial security of families and communities.   

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The Kaiser Family Foundation has released a short video slideshow that explains how Medicaid works now and what is at stake as policymakers in Washington consider converting program financing to a block grant or per capita cap. The video describes how Medicaid is funded under current law, whom it covers and how spending is distributed across various groups of enrollees, including children, adults, seniors, and people with disabilities.

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