Articles & Publications « Medicaid: « Benefits – Public
Articles re: Medicaid
- A Warning for Medicaid Beneficiaries Traveling Out of State (Sherabrams.com – 3/16/09)
Many Medicaid recipients don’t realize that their health insurance coverage may not provide a full set of benefits should they require care while out of state.
Patti's Comment: This is an important warning… - An Overview on Medicaid Eligibility for Nursing Home Care and Payment (Helium.com)
For starters, Medicare requires that a patient spend three midnights in the hospital before being admitted to a skilled nursing facility. With the push to get people in and out of hospitals, some doctors may be reluctant to keep the patient this long, so be prepared to play hardball. - Budget Ends the Only Therapy for Paralyzed Girl – TampaBay.com (Dec. 1, 2007)
State-mandated budget cuts mean no more funding for massage therapy for those with disabilities. - Elderly Medicare, Medicaid Patients Not Receiving Quality Care (Science Daily – Oct. 2007)
If the care received by vulnerable older people concurrently enrolled in Medicare and Medicaid was evaluated on a grading scale, it would squeak by with a barely passing mark, a new UCLA study has found. - Eligibility and Enrollment Processes for Medicaid, CHIP, and Subsidies in the Exchanges (ASJ – 9/24/10)
After the Patient Protection and Affordable Care Act (PPACA) became law, a state-based system of health benefit exchanges was established. This system will allow individuals to purchase coverage, with financial support for those between 133–400 percent of the federal poverty level, and expanding Medicaid eligibility to those with income below that level. - Exempt Medicaid Transfers (Thomas D. Begley, Jr., Esq.)
Patti's Comment: This is a great summary of transfers which are exempt from Medicaid penalties – written by a talented attorney! - Funding for People with Disabilities Targeted in New Medicaid Regs (Action Online)
New regulations for the Medicaid program, Targeted Case Management. - Give Disabled a Home Choice – (Sober at the Party blog – 3/2/09)
Under current Medicaid policy, disabled or elderly people who require assistance with daily activities are entitled to such services only if they reside in nursing homes. - Go to the Back of the Bus! (One Dad's Opinion Blog – Sept. 2007)
Regulations Proposed to Eliminate Federal Medicaid Reimbursement to Schools – an opinion from a dad raising an autistic child. - Health Care and Medicaid – Weathering the Recession (New England Journal of Medicine – 3/26/09)
Many have sought public coverage from the states through Medicaid, but Medicaid's ability to fill the gap is becoming increasingly constrained, as state revenues decline and states turn to Washington for help in paying their share of the Medicaid bill. - Improving Access to Home and Community-Based Services (Aging and Disability in America – 8/13/10)
Nearly five years ago, Congress amended Medicaid by adding Section 1915(i), intending to increase community-based services instead of institutional Medicaid services by permitting greater flexibility than Waivers permit. Unfortunately, only a few states took advantage of this. In enacting the Affordable Care Act in 2010, Congress made a number of additional changes which are extremely important to the disability community. However, unless your State opts to take advantage of these changes, they will not happen. These amendments take away many excuses the States have used in the past. - Major Changes in Both Medicaid and Medicare Affecting Your Clients (Sanford J. Mall, JD, CELA – Summer. 2007)
Recap of changes in law and policy that vastly affect basic health care, catastrophic medical, rehabilitation and long-term care for elders and persons with disabilities. - Medicaid – An Overview of Medicaid Eligibility and Benefits (About.com – 1/28/10)
Medicaid is an insurance program for low-income and needy people that provides health-related coverage for children, many seniors, and/or people who are blind or have other disabilities. - Medicaid and National Health Care Reform (New England Journal of Medicine – 10/14/09)
Defined by a history of both achievement and controversy, Medicaid has once again become central to the U.S. health policy debate, this time figuring as a key to national health care reform.
Patti's Comments: This is a good summary of some of the issues. - Medicaid Applying and Eligibility (Lift Chair Guide – May 2008)
While Medicaid is funded by both the federal government and the state government, it is, for the most part, in the hands of the states to provide the actual care. The federal government has a set of regulations that every state must follow. - Medicaid Coverage Explained (NPR – 10/7/09)
Medicaid is a joint federal-state program that provides health care coverage for low-income people — primarily children, pregnant women, parents, the disabled and the elderly. - Medicaid Tops Funding for Nursing and Residential Care Facilities (Kansas City infoZine – 1/16/09)
Medicaid continued to be the largest source of funding for nursing and residential care facilities in 2007 at $59 billion, according to the U.S. Census Bureau.
Patti's Comment: Medicaid is certainly NOT just a health insurance program. - Medicaid vs. Medicare (Disabled World – 10/11/10)
Just like there’s confusion over the difference between SSDI and SSI, there’s confusion over the difference between Medicare and Medicaid. So, here in a nutshell, is the definition of each.
Patti's Comment: If you have someone in the family with a disability of any age and your attorney cannot answer this question, get a new attorney! - Medicaid & Medicare (AGIS)
Discusses the differences between these complicated government programs. - Medicaid Waivers (2/8/09)
A blog entry from a woman with a child with Down syndrome about Medicaid waivers to help with what insurance won't cover. - Next Steps: Children can help mom best with advice of a lawyer (Post-Gazette – 11/25/08)
A good summary of Medicaid planning and the use of special needs trusts. - Nursing Home Medicaid (Wall Street Journal – 5/18/08)
Medicaid is commonly called the government health-care program for the poor, but it pays for more than two-thirds of long-term nursing-home stays. That means many middle-income Americans with savings will come to rely on the program. - Predicting the Future (Kaiser Family Foundation – 5/6/10)
A fair amount of attention was given recently to projections made by the Chief Actuary of the Centers for Medicare and Medicaid Services (CMS) about the new health reform law, and how they compare to previous estimates by the Congressional Budget Office (CBO). No doubt the various projections will be grist for claims made in the upcoming political season, so it is important to be clear about the differences between the two estimates and to keep in mind what this kind of statistical modeling does and does not do. - States Must Balance Declining Revenues with a Growing Need for Medicaid – (Families USA – 7/08)
As the economy heads into a recession, states are finding themselves in the difficult position of trying to make up for deficits in the current fiscal year. Also see Medicaid State Spending and Your State's Economy. - Study Spotlights Growing Role of Medicare in Propping Up Nation's Medicaid Program – (EMaxHealth – 10/07)
New BDO Seidman study of the nation's Medicaid program draws much needed attention to a chronic and worsening problem: Medicare's cross-subsidization of increasingly inadequate Medicaid payments for nursing home care.
Patti's Comment: I could not agree more! - The Basics on Medicaid and Medicare (Good Article)
The basics are described in this article. After reading through each program description, you will see how different and important Medicaid and Medicare are. - The Faces of Medicaid III: Refining the Portrait of People with Multiple Chronic Conditions (CHCS – 10/09)
Latest issue in the Faces of Medicaid series. Each iteration has brought warranted attention to the complexity of Medicaid's high-need, high-cost populations and the challenges inherent in designing cost-effective systems of care for them. - To Capture the Wild Pickle and Other Adventures in Medicaid Eligibility – (The Colorado Lawyer – May 2005)
When it comes to Medicaid eligibility, former lower-wage workers are sometimes treated worse than those who never worked. - U.S. Ruling Backs Benefit Cut at 65 in Retiree Plans – (New York Times – Dec. 27, 2007)
The Equal Employment Opportunity Commission said that employers could reduce or eliminate health benefits for retirees when they turn 65 and become eligible for Medicare. - Why Medicaid Should be Considered Sooner, Not Later (GrampsCare.com – 2/14/09)
Qualifying Gramps for Medicaid eligibility means being able to show that Gramps is practically broke, without appreciable assets and very little income.
Publications re: Medicaid
- Access to Long-Term Services and Supports: A 50 State Survey of Medicaid Financial Eligibility Standards (AARP – 2010)
This report provides a long-awaited update to existing data on Medicaid financial eligibility standards adopted by each state for older persons and adults with disailities. These standards serve as an important measure of access to Medicaid long-term services and supports in individual states. The report contains detailed information on Medicaid eligibility in all 50 states and the District of Columbia. - Briefing Document on Section 1915(c) Medicaid Waiver Service Definitions (Aging and Disability in America – 1/2/11)
Service definitions that focus on employment outcomes are an important component in communicating expectations and building system capacity to increase opportunities for people receiving Home and Community Based Services (HCBS) to participate in the general workforce. - Caring for People Covered by Both Medicare and Medicaid: A Primer on Dually Eligible Beneficiaries (Kaiser Family Foundation – 6/3/11) (video)
The panel will address such basic questions as: Who is dually eligible for Medicare and Medicaid? What are the characteristics and needs of this population? How do Medicaid and Medicare coordinate payment and care for this population? What federal and state barriers complicate these efforts? What is being done to address these challenges? What provisions in health reform address improving the coordination and delivery of services for dual eligibles? - Making Connections: Medicaid, CHIP and Title V Working Together on State Medical Home Initiatives (Nat'l Academy for State Health Policy)
The medical home model–an approach to offering excellent primary care–is gaining momentum. A wide range of stakeholders are now embracing medical homes, and the Affordable Care Act has dedicated resources to developing and spreading the model. In this context, states have been leaders in building medical homes – especially for vulnerable populations. - Medicaid Payment for Assisted Living (National Senior Citizens Law Center – Nov. 2010)
Medicaid has been paying for assisted living services for over 20 years, either through Home and Community-Based Services (HCBS) waivers, demonstration waivers, or state-plan services. To this point, the federal government has not established standards for Medicaid-certified assisted living facilities. State rules vary but resident protections tend to be limited. Despite growth in federal and state expenditures for assisted living, there has been scant public policy attention to how Medicaid funding for assisted living actually works in practice. - MMSEA & The MSP – Confusion Reigns Supreme – Medicare, Medicaid & SCHIP Extension Act (MMSEA)
Passage of Section 111 of the MMSEA and its reporting deadline of 7/1/09 has caused a tremendous amount of confusion among insurance professionals, lawyers and settlement planners alike. As a result of the MMSEA new discovery is being sought to assist insurers in complying with the reporting requirements. This article delves in the MMSEA briefly to explain what it is and what is required. - Protecting the Rights of Low Income Older Adults (NSCLC)
With support from the Commonwealth Fund, the National Senior Citizens Law Center undertook an extensive study of federal and state Medicaid policies for assisted living coverage – with a special focus on how such policies impact the lives of low-income older adults.
For information on Medicaid Fraud, click here.
