The Centers for Medicare and Medicaid Services (CMS) released proposed rules on February 22 to implement the Community First Choice Option enacted under section 2401 of the Affordable Care Act (ACA). This ACA provision enables a state to receive a six percentage point increase in its Federal medical assistance percentage (FMAP) effective October 1, 2011 for services under the new option if the state submits an approvable state plan amendment to CMS. CMS estimates that this could represent up to $3.7 billion in increased federal Medicaid reimbursement in the aggregate to all states. A state can obtain enhanced federal reimbursement on expenditures for consumer-controlled, home and community based attendant services and supports, where these services are provided to disabled individuals with low incomes (usually under 150 percent of the Federal poverty level) who need help with activities of daily living, instrumental activities of daily living, and health-related tasks. The new state plan option also allows enhanced federal reimbursement on other expenditures such as rent deposits, utilities deposits, and household furnishings, which may be needed immediately to help transition consumers from institutional to community settings, as well as skills development and training for consumers on how to select, manage, and (if necessary) dismiss attendants who aren’t satisfactory to them. Attendant services and supports may be provided through provider agencies or through methods such as vouchers, direct cash payments, and financial management entities such as PPL. The proposed rules will be published officially in the Federal Register on February 25 with a 60 day period for public comments.
About Tom Entrikin
A former policy specialist with the U.S. Health Care Financing Administration (now Centers for Medicare & Medicaid Services (CMS)), Tom Entrikin has vast experience providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; and Medicaid waiver programs.
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