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This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance.

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.

In passing the Patient Protections and Affordable Care Act (ACA) in 2010, Congress took arguably its most aggressive action toward rebalancing Medicaid long term services and supports (LTSS) spending in nearly three decades. However, since then, many states under budget pressure have put many Medicaid home and community-based care programs (HCBS) at risk. This new guide offers advocates a primer on the law that impacts Medicaid-funded HCBS. It also explains the different programs states can use to provide HCBS, including those created by the ACA. The guide highlights key resources and tools to use when advocating to expand and preserve Medicaid coverage of crucial LTSS services in individual states.

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.

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? 

Looking Ahead explains the key components of estate and long-term care planning. The book serves as a guide both for doing prudent planning before a future need arises and for dealing with a life event that is looming, generally the need for long-term care. The basic rules of Medicaid planning are explained.

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 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.

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. 

Proposals to drastically cut federal Medicaid spending through per capita caps and block grants would fundamentally alter and undermine Medicaid. NHeLP's Protect Medicaid webinar series examines the harmful impact of these proposals on key features of the Medicaid program, including: services and benefits geared for vulnerable populations; affordability and cost sharing protections; advances under the ACA's low income adult expansion; and consumer protections and due process guarantees.

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. 

This paper discusses the policy context driving the inclusion of more integrated permanent supportive housing (PSH) options within state and local behavioral health authorities, and builds on recent federal guidance regarding Medicaid reimbursement for housing-related services. State behavioral health authorities, Medicaid agencies and organizations serving people with MI and/or SUD each play a critical role working together to identify, pay for, and implement these types of services.