Re: FYI----Recommedations- on reforming Medicaid to clinets...

[Guest guest]

Question:

Could someone please explain " medicare waiver " . I don't mean to sound

ignorant, but I never saw the explanation of same. Many thanks.

Marie

[Guest guest]

Marie,

You don't sound ignorant at all. Your question is a very good one.

As you probably know, Medicare and Medicaid are U.S. government programs

that pay for medical care. Each program has certain requirements.

Waivers involve exceptions to specific federal requirements, often so

that services can be expanded or delivered in a different way than the

law normally requires. For example, waivers might include a waiver of

the " statewideness " requirement under Medicaid so that a new program can

be tested in a particular county before being expanded to an entire

state. Or waiver programs might target a particular population, such as

medically fragile children. Among the most interesting types of waivers

are waivers that permit services to be provided in the community instead

of in institutions such as nursing homes and developmental centers, thus

preventing unnecessary institutionalization of people with

disabilities. Below are some links to the Center for Medicare and

Medicaid (along with some quotes from the site), where you will find

more information. To find program information specific to your state,

you would want to contact authorities in your state. If you go to CMS

Contact Information Directory <http://www.cms.hhs.gov/contacts/> you

will find links to various organizations in your state, as well as to

CMS regional offices.

IHTH

What are Medicaid waivers? <http://www.cms.hhs.gov/medicaid/waiver1.asp>

A Medicaid waiver is when the Federal Government allows or grants States

permission to waive certain Federal requirements in order to operate a

specific kind of program. They are often used to authorize managed care,

or alternative delivery or reimbursement systems. In general, Federal

law allows States to enact three types of Medicaid waivers:

* Program Waivers <http://www.cms.hhs.gov/medicaid/waiver2.asp>

[1915(, 1915©, 1915(b)/1915© concurrent waivers]

* Research and Demonstration Waivers

<http://www.cms.hhs.gov/medicaid/1115/default.asp> [1115 waivers -

general]

* Health Insurance Flexibility and Accountability (HIFA)

<http://www.cms.hhs.gov/hifa/default.asp> (1115 Demonstration

Initiative)

State Waiver and Demonstration Programs

<http://www.cms.hhs.gov/medicaid/waivers/>

Demonstration Projects and Evaluation Reports

Demonstration Projects and Evaluation Reports

<http://www.cms.hhs.gov/researchers/demos/>

Demonstration Projects:

CMS conducts and sponsors a number of innovative demonstration projects

to test and measure the effect of potential program changes. Our

demonstrations study the likely impact of new methods of service

delivery, coverage of new types of service, and new payment approaches

on beneficiaries, providers, health plans, states, and the Medicare

Trust Funds. Evaluation projects validate our research and demonstration

findings and help us monitor the effectiveness of Medicare, Medicaid,

and the State Children's Health Insurance Program (SCHIP).

CMS Demonstration Projects under the Medicare Modernization Act

<http://www.cms.hhs.gov/researchers/demos/MMAdemolist.asp>

armarie@... wrote:

>Question:

>

>Could someone please explain " medicare waiver " . I don't mean to sound

>ignorant, but I never saw the explanation of same. Many thanks.

>

>Marie

>

>

[Guest guest]

Thank you so much for your information. I shall contact the site you

recommended.

Merry Christmas and Happy New Year.

Sincerely,

Marie

[Guest guest]

You're very welcome. Merry Christmas and Happy New Year to you, too.

armarie@... wrote:

>Thank you so much for your information. I shall contact the site you

>recommended.

>Merry Christmas and Happy New Year.

>

>Sincerely,

>Marie

>

>

>