http://goo.gl/XUu2cj
Currently, states receive waivers of federal Medicaid requirements in order to include home health and other services, and approximately 3 million individuals receive HCBS each year thanks to these waivers. Still, the amount of HCBS varies dramatically among states, in part because the process of getting waivers through state plan amendments (SPAs) is too complicated, the report states.
“Streamlining and consolidating existing waiver authority into a single SPA would assist states seeking to expand the availabilityof HCBS,” the authors write. “Combining features of existing SPAs would permit states to offer HCBS in a way that moves toward eliminating Medicaid’s bias for institutional or facility-based care, give states the flexibility and predictability they need to expand services to best address the needs of varying populations, and maintain essential provisions of federal law that allow individuals to direct their own care.”
Specifically, a streamlined waiver would encompass a number of features. These include:
Permitting states to offer services to people who do not require institutional-level care
Permitting states to cover any item or service that the Health and Human Services Secretary has approved for coverage under an HCBS waiver, including certain rehabilitative and respite care
Extend certain federal matching funds
In addition to the streamlined waiver process, HCBS services could be better supported by more affordable private insurance, the report proposes.