This document provides guidance on how States can, in the process of implementing the new federal regulations outlining new procedural requirements for managed care plans' grievance and appeal systems, ensure that people with disabilities have equal access to the grievance and appeal and State fair hearing systems, as mandated by Section 504 of the Rehabilitation Act ("Rehab Act"), the Americans with Disabilities Act ("ADA"), and Section 1557 of the Affordable Care Act ("ACA").
Reports & Publications
Researchers at the University of California conducted an evaluation of the implementation and impact of the CMC program on health systems and beneficiaries. This research brief examines the implementation of the new CMC care coordination benefit, including the progress made and challenges that remain in coordinating care for dual eligibles. Results are summarized from 94 key informant interviews with health system stakeholders.
Many people with disabilities who get paid help with daily activities also need help with health maintenance tasks, such as ostomy care, ventilator management, bowel and bladder care, tube feeding, insulin injections, and management of other medications. In many states, laws prohibit paid workers without nursing or other medical licenses from performing such tasks. In others, nurses are permitted to delegate such tasks to these workers. In some instances, such workers can perform health maintenance tasks under the direction of the consumer, without nurse delegation or supervision.
In January 2018, the Centers for Medicare and Medicaid Services (CMS) issued guidance that would allow states to use 1115 Waivers to add “work and community engagement” requirements for working-age Medicaid beneficiaries. This report examines the extent to which disability affects working-age Medicaid beneficiaries, and identifies the subset of beneficiaries with disabilities and work-limiting health conditions who would likely be exempt from proposed Medicaid work requirements or would benefit from modified requirements.
In 2014, California became one of 13 states to implement a financial and administrative alignment demonstration called the Coordinated Care Initiative (CCI). In California, existing Medicare and Medi-Cal (California’s Medicaid program) managed care health plans in seven counties created new products called “Cal MediConnect” (CMC). Researchers from the University of California conducted an evaluation of the impact of the CMC program on beneficiaries and health systems.