The District of Columbia operates a Medicaid home and community-based services waiver for individuals 65 years old or older or with disabilities. The waiver document it submitted to the Centers for Medicare & Medicaid Services (CMS), and for which it received approval, indicates that the “medically needy” are a covered eligibility category. However, DC advocates were recently informed by DC Medicaid officials that individuals with incomes over the “special income category” limit (300% of the Supplemental Security Income’s federal benefit rate) could not qualify for the waiver unless they established income trusts. Several organizations, including NSCLC, signed a letter directed to CMS asking that the agency clarify whether DC is required to provide coverage for medically needy individuals, and, if not, whether alternative methods are available for eligibility. Read letter.
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Unfinished Business: Designing Appeals Procedures in the Dual-Eligible Demonstrations helps stakeholders focus their advocacy about appeals on areas where a consumer voice can have the most potential to affect programs, by highlighting the many areas where appeal rights and procedures have not yet been fully developed. – December 2014
What’s In A Notice? How Notices Of Action Protect Consumers In Medicaid Managed Long-Term Services and Supports provides advocates with the specific information that must be included in each notice of action to meet due process requirements, and outlines how continuation of services and aid-paid-pending plays out in the managed LTSS context. – November 2014
Conflict Free Case Management: Themes in States Implementing New Systems provides background on conflict-free case management and reviews existing regulations and guidance. – October 2014
Action Steps for Consumers and Advocates Regarding the New Home Care Rule: How to Prevent Service Cuts and Protect Consumer-Directed Programs provides steps that consumers and advocates should take in their states to ensure proper implementation of new federal rule. – September 2014
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