On March 23, 2010, President Obama signed into law comprehensive health reform legislation, the Patient Protection and Affordable Care Act. The new law – referred to as the Affordable Care Act or ACA – contains several provisions that will expand coverage and improve the quality of care for low-income people with disabilities.
Basic highlights of the new law include:
- Requirement that all individuals have health insurance, and establishment of minimum standards for health insurance policies that can be purchased through state level Exchanges;
- Expansion of Medicaid coverage for all individuals under age 65 with incomes up to 133% of the federal poverty level;
- Parity coverage for mental health and substance abuse services;
- Creation of demonstrations and pilots to create medical homes for individuals with chronic conditions, and to improve overall efficiency and quality of care;
- Increased access to home- and community-based services for people with disabilities through Medicaid; and
- New long-term care options for people with disabilities.
TAC Publications
Presentations
News and Announcements
11/17/11: The
CMS Center for Medicare and Medicaid Innovation announced availability for grants of up to $30 million to support innovative approaches for caring for high cost/risk Medicare, Medicaid, and CHIP beneficiaries including those with mental health and substance use disorders. A total of $1B in funding is available. Models that can produce rapid improvements in the quality of life and health care for these populations while reducing costs are of particular interest under this funding opportunity. Applicants may include health care providers, non-profit organizations, faith-based organizations, payers and other private sector organizations, local governments, and for-profit organizations. Applications are due January 27, 2012. To view the notice of funding availability go to:
http://innovations.cms.gov/documents/pdf/innovation-challenge-foa.pdf
10/06/11: The Institute of Medicine (IOM) released on Friday its long-awaited report regarding the design of the Essential Health Benefits (EHB) package. Under the Affordable Care Act, the Secretary of Health and Human Services was charged with defining what benefits must be covered by health plans operating as part of state health insurance exchanges as well as under state Medicaid benchmark plans. The Secretary in turn requested the assistance of the IOM to propose suggested guidelines for HHS to use in its decision-making process for selecting the EHB. A copy of the full report can be downloaded at:
http://www.iom.edu/Reports/2011/Essential-Health-Benefits-Balancing-Coverage-and-Cost.aspx
9/20/11: CMS recently released a
State Medicaid Director Letter providing guidance to States on the State Balancing Incentives Program. States may take advantage of a time-limited increase in federal financial support available as part of this program, to shift the weight of spending toward home and community-based services as opposed to institutions. In order to take advantage of the increased FMAP that is available between October 1, 2011 and September 30 2015, qualifying States must make certain required structural changes that promote increased utilization of home and community-based services including:
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Creation of a “no wrong door single point of entry system”
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Development of “conflict-free” case management services
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Development of statewide, uniform, core standardized assessment instruments for determining eligibility for non-institutional services
How much FMAP States who apply and are selected for participation receive depends on their Medicaid spending on non-institutional services in 2009.
9/02/11: CMS recently announced they are accepting applications from States to participate in the new
Medicaid Emergency Psychiatric Demonstration, authorized by the ACA. Up to $75 million in funding is available to States over 3 years. The demonstration will allow selected States to provide payments to private psychiatric hospitals with 17 or more beds, known as Institutions of Mental Disease (IMD), for providing inpatient emergency psychiatric care to Medicaid recipients between 21 and 64. Current Medicaid rules do not permit States to claim FFP for services provided to adult Medicaid recipients in IMDs.
8/30/11: CMS recently released a
State Medicaid Director letter that offers guidance to states on making changes to their home and community-based services (HCBS) programs while still complying with the “maintenance of effort” (MOE) provisions in the Affordable Care Act. Accompanying the letter is a Q&A that discusses in part, how changes to HCBS waiver eligibility intersects with a state’s obligations under the ADA and Olmstead.
8/9/11: HHS Secretary Kathleen Sebelius announced the names of
67 grantees who will receive a total of $28.8 million in funding as part of the Affordable Care Act (ACA) to operate community health centers. These health centers are expected to serve an estimated 286,000 people. Community health centers play an important role in providing care to medically underserved and vulnerable populations. To read the HHS press release go to:
http://www.hhs.gov/news/press/2011pres/08/20110809a.html
7/15/11: On July 15, 2011, the Centers for Medicare & Medicaid Services (CMS), within the U.S. Department of Health and Human Services, made available approximately $2.1 million to fund State Medicaid Agencies to develop sustainable partnerships with State Housing Agencies that will result in long-term strategies to provide permanent and affordable rental housing for people with disabilities receiving Medicaid services and supports in the community.
Read full funding alert.
7/8/11: The Centers for Medicare and Medicaid Services (CMS) recently released a
State Medicaid Director Letter (SMDL) that provides initial guidance about an opportunity for States to participate in a 3 year demonstration that tests new payment and service delivery models for people who are dually eligible for Medicare and Medicaid.
5/13/11: The U.S. Department of Health and Human
Services announced the availability of over $100 million in funding for up to 75
Community Transformation Grants. Created by the Affordable Care Act, these
grants are aimed at helping communities implement projects proven to reduce
chronic diseases – such as diabetes and heart disease. By promoting healthy
lifestyles and communities, especially among population groups experiencing the
greatest burden of chronic disease, these grants will help improve health,
reduce health disparities, and lower health care costs. The official funding
opportunity announcement for the Community Transformation Grants can be found at
www.Grants.gov by searching for CFDA
93.531. For more information about the grants, visit
www.healthcare.gov/news/factsheets/grants05132011a.html or
www.cdc.gov/communitytransformation.
4/14/11: Fifteen states have been selected to receive State Demonstrations to Integrate Care for Dual Eligible Individuals grants. States will be awarded up to $1 million to develop approaches to better coordinate care for people who are dually eligible for
Medicaid and Medicare. For more information go to: http://www.cms.gov/dualeligible/
3/31/11: The Centers for Medicare and Medicaid Services (CMS)
proposed new rules under the Affordable Care Act to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs).
3/8/11: The Department of Justice asked the 11th Circuit Court of Appeals for an expedited review of U.S. District Judge Roger Vinson's ruling that the individual mandate to have health insurance contained within the ACA was unconstitutional, thereby making the entire law void.
http://www.justice.gov/healthcare/docs/motion-for-expedition-03112011.pdf
2/28/11: The Center for Medicaid, CHIP and Survey & Certification (CMCS) recently released an
Informational Bulletinn with details regarding: the
Community First Choice Option proposed rule; the new
Money Follows the Person grantees; the funding opportunity under section 4108 of the ACA for
Medicaid Prevention Grants; and the
State Medicaid Director Letter on the
Maintenance of Effort requirements under the ACA. In addition the bulletin also contains links to webinars recently convened by CMS for the states on:
For more information
Healthcare.gov website of the U.S. Department of Health and Human Services on health care reform
