Policy Issues & Resources: Medicaid

Medicaid spending accounts for more than 21% of state spending, with a projected growth rate of 8% annually through FY 2018. Medicaid is the single largest source of funding for America's public mental health system.

In 2009, the Department of Health and Human Services (HHS) rescinded several harmful Medicaid regulations including: parts of targeted case management, outpatient hospital and clinic services upper payment limit, school-based services, and rehabilitation. The announcements were published in the Federal Register on June 30, 2009 and on Nov. 23, 2009.

On February 16, 2009, President Obama signed the American Recovery and Reinvestment Act (ARRA) into law. The ARRA provided a temporary increase in the Federal Medical Assistance Percentage (FMAP) payments to states to help them continue to provide healthcare for needy families.

Recent News  I  Official Comments  I  Official Letters  I  State Activities
Deficit Reduction Act  I Issue Briefs  I  Fact Sheets  I  Summaries & Charts
Additional Resources

Recent News 

• Administration Grants $4.3B in Relief to States on Medication Payments for Dual-Eligibles
• States Receive Guidance on Implementing Express Lane Eligibility for Medicaid/CHIP
• Senate Votes to Approve Jobs Bill; FMAP Extension May Be Included in Upcoming Round of Legislation
  

Official Comments

• Advanced Notice of Proposed Rulemaking Changes to the Medicaid HCBS Waivers (CMS-2296-ANPRM)
• Proposed Rule on Benchmark Plans (CMS-2232-P)
• Proposed Rule on Cost Sharing (CMS-2244-P)
• Interim Final Rule on Targeted Case Management (CMS-2237-IFC)
• Proposed Rule on Home and Community-Based State Plan Services (CMS-2249-P)
   

Official Letters

• Sign on Letter in Support of Including Therapeutic Foster Care in Healthcare Reform
• Partnership for Medicaid Sign on Letter in Support of Expanding Medicaid Eligibility to 150% of the Federal Povery Level
• Sign on Letter in Support of Simplifying Medicaid Eligiblity & Allowing Reimbursement for Coordinated Care
• The National Council signed onto a letter of support for an amendment to the Affordable Health Choices Act be offered by Rep. Christopher Murphy, which would help restore Medicaid benefits to youths transitioning from secure facilities back to the community.
• Letter to Senate and House Leadership Asking for an Increase to the Federal Medicaid Share
• Letter from Senator Max Baucus (D-MT), Chairman of the Senate Finance Committee, and Representative John Dingell (D-MT), Chairman of the House Energy and Commerce Committee, to CMS clarifying Congressional intent on the issue of the intrinsic element/integral component standard in the Interim Final Rule on Case Management
• National Council Joins More than 60 Groups in Sending Letter in Support of Legislation to Delay Seven Medicaid Regulations for One Year
• Partnership for Medicaid Letter to House and Senate Leadership Voicing Concern Over Recent Administration Actions that Affect Medicaid.
• Letter of Thanks for Opportunity to Testify at Nov. 1 Hearing on “The Administration’s Regulatory Actions on Medicaid: The Effects on Patients, Doctors, Hospitals and States.”
• Letter to Congressional Leaders Requesting One-Year Delay in Rule Requiring Medicaid Prescriptions to be on Tamper-Resistant Pads
• Letter to CMS re. Approval Process for Medicaid Waivers Under Section 1115 of Social Security Act
• Letter to Senator Coleman in Support of Legislation to Place Moratorium on TCM and Rehab Rules 
• Letter to House Leadership in Support of Protecting the Medicaid Safety Net Act of 2008
• Letter in Support of The Economic Recovery in Health Care Act
• Letter in Support of an Increase to the FMAP Federal Match and a Moratorium on the Outpatient Clinic Rule
   

State Activities

• West Virginia Medicaid Medical Home Evaluation
• Comments to Oregon Medicaid Agency Opposing Increase in Copays for Prescription Medicines
• Iowa Receives Federal Approval to Add Home-and Community-Based Services Option
• Medicaid Reform in West Virginia — a Consensus Statement
   

Deficit Reduction Act

• Final Rule on Changes to Federal Cost Sharing Rules
• Overview of the Deficit Reduction Act
• Expanded Medicaid Coverage Under the DRA
• Medicaid Services for Children Under the DRA
• State Implementation of the DRA
  
• Medicaid Compliance Issues
  
• Summary of State Activity
   

Issue Briefs

• Coverage of Newborns
   

Fact Sheets

• Final Rules on Changes to Cost Sharing Rules December 2008
• Join Statement on Medicaid Reform Principles
• Impact of Medicaid Cost-sharing on Health Care Access June 2007
   
• Targeted Case Management 
• Rehabilitative Services Option
• Joint Statement on Medication Cost Sharing in State Medicaid Programs
• CMS Clarification on Tamper-Resistant Prescription Features
• Money Follows the Person Rebalancing Demonstration
   

Summaries & Charts

• Summary of Medicaid Provisions of the ARRA
• Summary of the Health Information Technology Provisions of the ARRA
• Summary of CMS's Proposed Rule for the State Plan HCBS Benefit
• Chart of Current CMS Regulations
• Overview of The American Public Human Services Association (APHSA) Comparison of Areas of the TCM Interim Final Rule that Extend Beyond the Authorization of the DRA Conference Report
• Chart of APHSA comparison
• Summary of CMS's Targeted Case Managed Proposed Rule
• Summary of National Council Town Hall Meeting on the TCM Proposed Rule
  
  

  Additional Resources

• CMS presentation on 15-minute Billing Increments for Rehabilitation and Targeted Case Management services
• Briefs Examine HCBS
• Baldwin Amendment to the Affordable Health Choices Act which would clarify Medicaid reimbursement for therapuetic foster care.  It was accepted by voice vote in the Energy and Commerce Committee on July 30, 2009.
• CMS  FAQ Sheet on Medicaid and the ARRA
• Updated Data on Federal Match Rate Implemented Due to ARRA
• CMS Guidance to States on implementation of the Targeted Case Management moratorium
• CMS new template for state plan amendments
  

• Memo from the Center on Budget and Policy Priorities and the Georgetown Health Policy Institute on the case management moratorium

• CMS Q&A on Case Management
• Manager's Amendment to the Protecting the Medicaid Safety Net Act of 2008 (HR 5613), Approved by the House Energy and Commerce Health Subcommittee by Voice Vote on April 9, 2008
• CMS Clarification on Tamper-Resistant Prescription Features
• Provider Toolkit on New Citizenship and Identity Documentation Requirements for Eligibility