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In 2009, the Department of Health and Human Services (HHS) rescinded several harmful Medicaid regulations including: parts of targeted case management, outpatient hospital and clinic services upper payment limit, school-based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. In March of 2010, the Patient Protection and Affordable Care Act, also known as national healthcare reform, became law. Healthcare reform includes important changes and expansions to the Medicaid program that will be enacted over the next decade.

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 

• Federal Judge Blocks Cuts to Medicaid in California
• HHS Awards Bonuses to States for Enrollment of Children in Health Coverage
• President Obama Nominates Marilyn Tavenner to Head CMS

Official Comments

• Amicus brief submitted in Douglas v. Independent Living Center of Southern California, regarding the effect of Medicaid provider payment on beneficiaries' access to care
• Comments to CMS on Section 1115 Waiver Review Process
• 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

• Letter from the National Council and 18 national mental health organizations in support of extending the FMAP increase
• 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
• Paper from the Partnership for Medicaid coalition that provides Medicaid reform options that would create efficiencies and improve the quality of care offered to Medicaid beneficiaries.
   

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

• Proposed 2012 Budget Plan Would Slash Medicaid, Put Beneficiaries at Risk
• Healthcare Reform and Medicaid Expansion
• Enrollment in Medicaid Expansion and the State Health Exchanges
• 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

• American Psychiatric Association Talking Points on Medication Access Issues in Medicaid
• CMS presentation on 15-minute Billing Increments for Rehabilitation and Targeted Case Management services
• Briefs Examine HCBS
• CMS  FAQ Sheet on Medicaid and the ARRA
• Updated Data on Federal Match Rate Implemented Due to ARRA
• CMS new template for state plan amendments
• CMS Q&A on Case Management
• CMS Clarification on Tamper-Resistant Prescription Features
• Provider Toolkit on New Citizenship and Identity Documentation Requirements for Eligibility
• American Psychiatric Association Website with information for psychiatrists who serve patients through Medicare and Medicaid