On January 27, 2023, the Centers for Medicare & Medicaid Services released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” The SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.
Approaches to the Integration of Services for Individuals with Intellectual and Other Developmental Disabilities
Brendan Hogan, Kate Bazinsky, and Beth Waldman, Bailit Health Purchasing
Today, there is a great deal of focus on integration of physical and behavioral health care services within the health care system overall, as well as within state Medicaid programs. Individuals with intellectual and other developmental disabilities (I/DD) often have multiple physical, behavioral, and long-term services and support (LTSS) needs. Many advocates of integration suggest that the consolidation of these services can provide an opportunity to improve care for individuals with I/DD. Based on interviews conducted with I/DD staff in six states (Arizona, Kansas, Michigan, New York, Tennessee, and Vermont), this paper highlights approaches to integrating services within the Medicaid program for individuals with I/DD, and lessons learned from states with integration activities underway.