HCBS Settings Rule Issue Briefs

This week’s In Focus section highlights four briefs written by Health Management Associates (HMA) in collaboration with the National Council on Assisted Living that address key areas of compliance with the Centers for Medicare & Medicaid Services (CMS) home and community-based services (HCBS) settings final rule. The briefs are intended to inform states and Assisted Living (AL) communities on common challenges facing AL communities, the strategies for compliance available, and the steps states have taken to address them in their approved statewide transition plans. To create the briefs, HMA analyzed the regulations, CMS guidance, and the statewide transition plans that had received final approval from CMS at the time of writing. State plans reviewed were: Arkansas, District of Columbia, Delaware, Kentucky, Oklahoma, Tennessee, and Washington.

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SNP Provisions of the Bipartisan Budget Act of 2018

This week’s In Focus section reviews the recent Bipartisan Budget Act of 2018 (the Act), which adopts policies aimed at improving care for Medicare beneficiaries with chronic conditions, including individuals dually enrolled in Medicare and Medicaid (dual eligible individuals). The Act provides new authority to the Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office or MMCO), which serves dual eligible individuals, and will help accelerate its goals of providing full access to seamless, high quality health care and a system that is as cost-effective as possible.[i] The Act also includes several provisions that have an impact on Medicare Advantage (MA) Dual Eligible Special Needs Plans (D-SNPs). These provisions and their implications for D-SNPs and Medicare-Medicaid integration strategies follow.

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Puerto Rico Releases Government Health Plan RFP

This week’s In Focus section, written by HMA Principal Juan Montanez, reviews the request for proposals (RFP) issued by Puerto Rico earlier this month to deliver managed care services to the territory’s Government Health Plan (GHP) members. The government of Puerto Rico is seeking to contract with between three and six MCOs to provide services to the approximately 1.3 million members of the GHP, the territory’s medical assistance and insurance affordability program. Proposals in response to the recently issued RFP are due in early April.

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