Tuesday, January 7, 2014

Medicaid Coverage of LTSS

The Congressional Research Service has released a report, Medicaid Coverage of Long-Term Services and Supports. Written by Kirsten J. Colello, this 29 page report offers some background information as well as details about specific LTSS.  An excerpt of the summary details the information in the report:

Long-term services and supports (LTSS) refer to a broad range of health and health-related services and supports needed by individuals who lack the capacity for self-care due to a physical, cognitive, or mental disability or condition. Often the individual’s disability or condition results in the need for hands-on assistance or supervision over an extended period of time. Medicaid plays a key role in covering LTSS to aged and disabled individuals… LTSS are also a substantial portion of spending within the Medicaid program relative to the population served, accounting for over one-third (35.6%) of all Medicaid spending....

Medicaid funds LTSS for eligible beneficiaries in both institutional and home and community-based settings, though the portfolio of services offered differs substantially by state. Moreover, states are required to offer certain Medicaid institutional services to eligible beneficiaries, while the majority of Medicaid home and community-based services (HCBS) are optional for states. In recent decades, federal authority has expanded to assist states in increasing and diversifying their Medicaid LTSS coverage to include HCBS....

States now have a broad range of coverage options to select from when designing their LTSS programs. In general, Medicaid law provides states with two broad authorities, which either cover certain LTSS as a benefit under the Medicaid state plan or cover home and community-based LTSS through a waiver program which permits states to ignore certain Medicaid requirements in the provision of these services. Given the range of available coverage options, states continue to enhance or expand their LTSS delivery systems to cover additional services or target services to specific populations with a focus on HCBS. …  Finally, states reported efforts to implement demonstrations and other grant activities to enhance or expand their LTSS delivery systems ….

This is a great resource in helping the reader understand more about Medicaid's LTSS program.

 

 

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