“The Department of Health, Developmental Disabilities Division, has issued the updated Medicaid Waiver Provider Standards for Individuals with Intellectual and Developmental Disabilities (Medicaid I/DD Waiver), Version B-3. The Standards reflect changes based on the CMS-Approved I/DD Waiver Amendment #2 and are effective in November 2018.”
“North Carolina today received federal approval to implement the transition to Medicaid managed care and integrate physical health, behavioral health and pharmacy benefits. Receiving approval from the Centers for Medicare & Medicaid Services (CMS) of the amended 1115 Demonstration Waiver application submitted by the North Carolina Department of Health and Human Services in 2017 is a major milestone in implementing North Carolina’s Medicaid Transformation and in moving the state’s health care system toward further integration and coordination.”
“Pursuant to Chapter 47 of the Acts of 2017, this study examines the opportunities and challenges associated with allowing small employers to share premiums with or “buy into” MassHealth, the Commonwealth’s Medicaid program. Premium sharing would split the cost of covering employees who are eligible for the MassHealth program between MassHealth and the employer, while a buy in program would allow employees to enroll in a Medicaid benefit at any income but without subsidies and without federal “match” funding. Such a program could take many forms and achieve many different goals. This study outlines several approaches to premium sharing and buy-in programs and offers potential considerations for the General Court should it choose to approach this issue in the future.”
“Waivers are agreements between the Centers for Medicare and Medicaid Services (CMS) and a state’s Medicaid agency and serve specific groups of people.
Waivers specify:
• Number of participants to be served
• Eligibility criteria
• Available services, including any limits on services
• Procedures for the evaluation and re-evaluation of level of care
Waivers give eligible people options if their needs can be met in their homes, and if providing services in a home and community setting is cost neutral compared to institutional services.”
“Remediation for HCBS Final Rule (79 FR 2947) on Community Integration Through its process of validation and monitoring of Providers, DOH-DDD will ensure that settings meet HCBS final rule requirements by maximizing opportunities for participants to have access to the benefits of community living and opportunities to receive services in the most integrated setting.
a. Setting requirements include but are not limited to the following:
“Purpose
This policy establishes the process and procedures for transitioning eligible individuals from institutional care settings onto the Frail and Elderly (FE), Intellectual and Developmental Disability (I/DD), Physical Disability (PD), and Traumatic Brain Injury (TBI) waiver programs. “
“An Institutional Transition moves residents of qualified institutional settings into the community. This process identifies individuals who have expressed their desire to return to the community and provides them with community supports to aid them in maintaining residence in the least restrictive setting of their choice. Institutional Transitions are available if you are eligible for the Frail Elderly (FE), Physical Disability (PD), Brain Injury (BI), or Intellectual/ Developmental Disability (IDD) waiver. Individuals completing an Institutional Transition to a waiver with a current waiting list can bypass the waiver waitlist.”
“The Wyoming Department of Health (Department) is the single state agency designated to administer the Wyoming Medicaid program, and submits this Statewide Transition Plan (STP) in accordance with the federal regulation. This document shall describe the Department’s efforts in the following areas:
• Assessment of current HCB settings for compliance;
• Assessment of state policies and procedures to support HCB settings compliance
• Development of technical assistance tools and overall approach to transitioning providers and settings into HCB compliance; and
• Assuring ongoing compliance with federal and state regulatory requirements”
“The Centers for Medicare & Medicaid Services (CMS) recently released new regulations and guidance on the delivery of home and community-based services (HCBS) offered through Medicaid waiver programs. Through this new rule, CMS intends to ensure that individuals receiving HCBS through Medicaid waivers have full access to integrated, community living including receiving services in the most integrated setting possible. To increase understanding of the rule for individuals receiving services, family members and providers, the West Virginia Bureau for Medical Services will post information and relevant materials on this webpage.
To fully implement the new rule from CMS, West Virginia must submit a transition plan for the each Medicaid waiver offering HCBS to ensure compliance of the new rule. The Bureau for Medical Services is solicited comments on the draft Transition Plans. There is one transition plan for each waiver. The transition plans will be combined into one Statewide Transition Plan. Comments from the public will be used to complete the final Statewide Transition Plan to submit to CMS.”
“Adult Intellectual and Developmental Disabilities Waiver Redesign Stakeholders provide guidance and advice to the Department on the development and implementation of a redesigned waiver to support adults with intellectual and developmental disabilities.
The redesigned waiver will offer an array of services and supports that are flexible to the needs and preferences of the individuals who receive them, are available when and where they are needed, and incorporate the following principles:
• Freedom of choice over living arrangements, social, community, and recreational opportunities
• Individual authority over supports and services
• Support to organize services in ways that are meaningful to the individual receiving services
• Health and safety assurances
• Opportunity for community contribution
• Responsible use of public dollars”