CMS Encourages Innovation

CMS Encourages Innovation
September 1, 2001

Since January 22, the Centers for Medicare & Medicaid Services, formerly the Health Care Financing Administration, has approved 910 new and pending Medicaid and SCHIP amendments and waivers. Among them:

California's plan amendment to allow children to remain covered by the state's Medi-Cal program continuously for 12 months once found eligible for the program. The coverage would continue regardless of changes in income, resources, or family structure. The change doubles the average length of time children are on the Medi-Cal rolls and will result in an additional 390,000 children retaining eligibility on a monthly basis.

Florida's plan to include the Healthy Start Coordinated Care System for Pregnant Women and Infants as a part of the state's overall managed care system known as MediPass. The change will improve the integration of services for pregnant women and infants. In addition, the waiver approval allows Florida to integrate the Children's Medical Service Network, for children with special health care needs, into MediPass.

State plan amendments in Florida and South Carolina that provide personal care services to the states' medically fragile elderly Medicaid populations. Under the new system, each state provides an integrated set of personal care services, based upon a care plan developed by a licensed practitioner, which may include assistance with bathing, dressing, eating, grooming, managing finances, and shopping. These services are available on a 24-hour basis in a non-medical environment that promotes independence.

Minnesota's request to amend its Pre-Paid Medical Assistance Program Demonstration to enable the state to implement county-based purchasing in nine rural counties known as the South Country Health Alliance. The alliance will serve as the managed care provider for about 10,000 eligible residents. The program will allow the counties to better integrate those residents' health care services with other related services already provided through the counties, including housing and social service programs.

New York's Family Health Plus, which will provide health coverage to about 600,000 eligible single adults and parents who do not have health insurance through their employers but make too much to be eligible for traditional Medicaid coverage. The plan covers eligible single adults with incomes up to 100 percent of the federal poverty level, and eligible adults with children and incomes of up to 150 percent of the federal poverty level.

Wisconsin's waiver request for Family Care, which provides home- and community-based services through county-operated Care Management Organizations and offers "one-stop shopping" to assist consumers in learning about available services. The goal of Family Care is to increase the capacity of the home- and community-based services through the use of managed care efficiencies, thereby reducing waiting lists. The program is part of Wisconsin's planned redesign for its long-term care system.

Plan amendments from 10 states to expand Medicaid benefits to uninsured women diagnosed with breast or cervical cancer through the Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 created a state option to extend the full Medicaid benefits package to women diagnosed through this key prevention program. Eight more states have similar plan amendments that are expected to be approved shortly.