Medicaid Update
Verma Outlines Vision for Medicaid, Announces Historic
Steps Taken to Improve the Program
New Policies Help Ensure
States Can Focus More Resources, Time Achieving Positive Health Outcomes for
Beneficiaries
Today, Centers for Medicare & Medicaid Services (CMS)
Administrator Seema Verma discussed her vision for the future of Medicaid and
unveiled new CMS policies that encourage states to propose innovative Medicaid
reforms, reduce federal regulatory burdens, increase efficiency, and promote
transparency and accountability during a plenary session at the National
Association of Medicaid Directors (NAMD) Fall Conference in Arlington,
Virginia.
During her first major speech on the subject, Verma noted
that when the federal government established Medicaid, it was intended to be a
partnership with state governments to care for society’s most vulnerable
citizens. With the growth of the program over the last several years came
increased federal and state spending, which naturally meant increased federal
oversight and regulation, said Verma.
“Our vision for the future of Medicaid is to reset the
federal-state relationship and restore the partnership, while at the same time
modernizing the program to deliver better outcomes for the people we serve,”
said Administrator Verma. “We need to ensure that we are building a Medicaid
program that is sound and solvent to help all beneficiaries reach their highest
potential.”
Verma emphasized her commitment to “turn the page in the
Medicaid program” by giving states more freedom to design innovative programs
that achieve positive results for the people they serve and pledged to remove
impediments that get in the way of states achieving this goal. She announced
several new policies and initiatives that break down the barriers that prevent
state innovation and improvement of Medicaid beneficiary health outcomes:
Web Site Content on Section 1115 Demonstrations: CMS
updated Medicaid.gov to give states a clearer indication of how their reform
strategies might align with a core objective of the Medicaid program: serving
the health and wellness needs of the nation’s vulnerable and low-income
individuals and families. The revised web site content signals a new, broader
view of Section 1115 demonstrations, in which states can focus on evidence-based
interventions that drive better health outcomes and quality of life
improvements. The update signals CMS’s willingness to work with state officials
requesting flexibility to continue to provide high quality services to their
Medicaid beneficiaries, support upward mobility and independence, and advance
innovative delivery system and payment models.
In a significant shift from prior policies, in speaking
about the new approach to Section 1115 demonstrations, Verma emphasized the
agency’s commitment to considering proposals that would give states more
flexibility to engage with their working-age, able-bodied citizens on Medicaid
through demonstrations that will help them rise out of poverty. As Medicaid has
expanded to able-bodied individuals, the needs of this population are even more
imperative, she said. During her remarks, the Administrator made it clear that
CMS will openly consider proposals that promote community engagement and work
activities.
“Every American deserves the dignity and respect of high
expectations and as public officials we should deliver programs that instill
hope and say to each beneficiary that we believe in their potential,” said
Administrator Verma. “CMS believes that meaningful work is essential to
beneficiaries’ economic self-sufficiency, self-esteem, well-being, and health
of Americans.”
Streamline and Improve 1115 Demonstration, State Plan
Amendments, and 1915 Waiver Processes: CMS released several new
policies that improve federal and state program management, specifically
through improvements in the review, approval process, and monitoring of 1115
Demonstrations and Medicaid and Children’s Health Insurance Program (CHIP)
state plan amendments (SPA) and 1915 waivers. Taken together, these policies
include provisions that will allow states to:
- Request
approval for certain 1115 demonstrations for up to 10 years;
- More
easily pursue “fast track” federal review, which makes it easier for
states to continue their successful demonstration programs;
- Spend
time administering innovative demonstrations by reducing certain 1115
reporting requirements;
- Expedite
SPA and 1915 waiver efforts through a streamlined process and by
participating in a new “within 15-day” initial review call with CMS
officials.
In addition, the policies will improve how waivers and
demonstration projects are monitored and evaluated. Waivers and demonstration
projects that are less complex and have been running smoothly will require much
less reporting, and waivers and demonstration projects that have a good track
record of producing positive results will find an easier path to renewal. In
her remarks, the Administrator underscored that these new policies were
intended to relieve the regulatory burden on states, avoid increasing
administrative costs for taxpayers, and refocus time and resources on improving
the health outcomes of Medicaid beneficiaries.
Creation of First-Ever Medicaid and CHIP Scorecards:
CMS is in the early stages of developing Scorecards that will provide greater
transparency and accountability of the Medicaid program by tracking and
publishing state and federal Medicaid outcomes. In her remarks, Verma said that
the Scorecards were a “historic opportunity” to demonstrate to taxpayers that
their hard-earned tax dollars were being spent appropriately. In addition, the
reporting will provide validation to Medicaid beneficiaries that the $558
billion spent on Medicaid is producing positive results and improved health
outcomes.
To close her remarks, Administrator Verma noted that federal
and state officials have a higher purpose than “just handing out Medicaid cards
and being a financier of healthcare.” She stressed that the Administration’s
new vision for Medicaid, and the new policy changes outlined today represented
the results of a promise to Medicaid beneficiaries and to the American people
that fund the program.
“We will not just accept the hollow victory of numbers
covered [in the program], but will dig deeper and demand more of ourselves and
of you,” said Verma. “For those unable to care for themselves, we will create
sustainable programs that will always be there to provide the care you need, to
provide choices and allow you to live as independently as possible. For those
that just need a hand up, we will provide you the opportunity to take charge of
your health care and assist and empower you to rise out of poverty and
government dependence to create a better life for yourselves and your family.”
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