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Medicaid Rule Change Strengthens Home- and Community-Based Care

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By Hook Law Center

Millions of low- and fixed-income Americans depend on Medicaid for health care. Many are fortunate enough to receive that care in their homes or at nearby facilities. Unfortunately, some have no choice but to receive treatment in nursing homes and in other institutional settings that may be nowhere near their homes, friends and family. Such situations are widely recognized to be less conducive to a patient’s overall well-being.

The Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees those programs, recently announced new rules to strengthen the Community Living Initiative — a program launched in 2009 to develop strategies to increase Medicaid recipients’ opportunities for care in home- and community-based settings (HCBS).

The new rules set definitions for HCBS and specify that Medicaid will support HCBS programs that offer an alternative to care in institutional settings and that take into account a patient’s quality of life. States will be granted a transitional period during which they can ensure their HCBS programs meet requirements. During this period, states will be provided with technical assistance.

The new rules give states more options for expanding HCBS and for targeting specific segments of the population. They also streamline regulatory and documentation procedures for more efficient operations.

The elderly, ill, disabled and low-income populations are all vulnerable to marginalization. Institutionalized care, while necessary and beneficial for some, can be a prime example of such marginalization when not medically necessary. Those who will become able to receive care in their homes and communities because of these changes stand to benefit immensely from the CMS’s new rules.

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Posted on Friday, February 28th, 2014. Filed under Medicaid.