Deficit Reduction Act 

PCG continuously monitors changes in law, regulation, and policy that create new opportunities for our clients. The Deficit Reduction Act, signed by the President in February 2006, contains several provisions that are especially relevant to our clients:

• Medicaid may offer home and community-based services as an optional Medicaid State plan service.  CMS waivers are not needed, persons need not meet a level of care test, and persons may “self direct” purchase and control of the services within individualized budgets.   
• States may cover self-directed personal assistance services for persons who would otherwise require these services under the State Medicaid plan or under a home and community-based services waiver.  Persons may purchase the services themselves and may hire, fire, supervise, and manage their caregivers.  
• States may obtain approval of demonstration projects, increasing Medicaid’s use of home and community-based services to reduce institutionalization.   States may receive 75-90% FFP on services provided to individuals for 12 months following their discharge from the institution if they resided in the institution for the preceding 6 months and meet a level of care test in the community. 
• States may obtain special funding at 100% FFP to study Medicaid innovations on use of electronic health records, decision support tools, improving estate recovery, reducing payment errors, medication management, promoting use of generic drugs, utilization control, and improving access to primary care for the uninsured.