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CMS releases guidance on COVID-19 relief funds for state Medicaid programs

The guidance is meant to assist states in leveraging federal resources to enhance equity in Medicaid beneficiaries' access to HCBS services.

Jeff Lagasse, Associate Editor

Photo: supersizer/Getty Images

The Centers for Medicare and Medicaid Services issued guidance last week on how states could receive enhanced funding through the American Rescue Plan to increase access to home and community-based services for Medicaid beneficiaries.

Benefits for home and community based services are geared toward older adults and those with disabilities that allow them to receive health services in their homes rather than in assisted living facilities and other institutions.

The guidance is meant to assist states in leveraging federal resources to enhance equity in Medicaid beneficiaries' access to these services.

The additional funding allows states to tailor enhancements of home and community services based on the needs and priorities of their residents, while protecting and strengthening the home and community based services workforce. Other benefits touted by CMS include safeguarding financial stability for HCBS providers, accelerating long-term services, and supporting reform and innovation.


Section 9817 of the ARP provides states with a temporary 10 percentage-point increase to the federal medical assistance percentage for certain Medicaid HCBS from April 1 through March 31, 2022 to improve HCBS under the Medicaid program. 

The guidance that was issued to states via a State Medicaid Director Letter outlines the eligible services and parameters for which states can claim the increased FMAP, and provides examples of activities that states can implement to enhance, expand, or strengthen HCBS.

Millions across the U.S. rely on home-based care, and the workforce that provides that critical care, CMS said.


It's been a busy month on the home care front, with UnitedHealthcare announcing last week that it would soon launch UnitedHealthcare Healthy at Home, an offering designed to help retirees safely transition back home after discharge from a hospital or skilled nursing facility.

Created specifically for Group Retiree Medicare Advantage plans, it's geared around providing access to benefits addressing a scope of social needs, with an eye toward keeping retirees healthy in their homes.

The same week, Mayo Clinic and Kaiser Permanente invested in Medically Home Group, a Boston-based technology company that allows patients to receive acute-level care and recovery services at home. Forbes estimated the partnership will begin with a $100 million combined investment.

In March, America's Health Insurance Plans submitted testimony to the Senate Health, Education, Labor, and Pensions Committee for a hearing focused on improving health equity and outcomes by addressing health disparities during the COVID-19 response. AHIP highlighted health insurers' efforts to address factors such as social determinants of health that can impact the equity of care patients receive.

AHIP floated a number of policy recommendations, and said that efforts could be aided by Medicaid expansion, HCBS funding and extended postpartum coverage.

"Throughout the pandemic, the Medicaid program has provided essential healthcare services to millions of Americans who otherwise could not afford health coverage," AHIP wrote. "To ensure that Medicaid remains a stable resource, we urge Congress to take legislative action to support permanent funding for Medicaid expansion incentives, HCBS and extended postpartum coverage. This support is necessary not just for the care delivered today, but the care that will be delivered in the future after the pandemic has subsided."

In September 2020, a working paper from the Mercatus Center argued that removing labor market barriers and technical barriers to entry are vital for realizing the benefits of in-home healthcare, including telehealth.


"The Biden-Harris Administration continues to support states and workers by making critically needed investments in home and community based services," said Health and Human Services Secretary Xavier Becerra. "The American Rescue Plan helps to ensure that states can benefit from an increased federal investment in HCBS systems across the country, so that Medicaid beneficiaries receive high quality, cost-effective, person-centered services in their homes and remain a valued part of their communities."

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