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Medicaid program; home and community-based services--HCFA. Final rule
Federal Register
|February 21, 1985
Summary
This rule updates Medicaid regulations for home and community-based services, allowing states to offer more options to avoid institutionalization for individuals. It clarifies eligibility and financial requirements for these essential Medicaid waiver programs.
Area of Science:
- Health Policy
- Social Services
- Public Health
Background:
- Medicaid regulations from 1981 governed home and community-based services.
- Section 2176 of the Omnibus Budget Reconciliation Act of 1981 enabled state-specific waivers for these services.
- The need for alternatives to institutionalization has driven policy development.
Purpose of the Study:
- To amend interim final Medicaid regulations concerning home and community-based services.
- To implement changes mandated by section 2176 of the Omnibus Budget Reconciliation Act of 1981.
- To provide final guidance on state waiver programs for long-term care alternatives.
Main Methods:
- Review and amendment of existing Medicaid regulations.
- Establishment of standards for facilities providing waiver services.
- Revision of cost-effectiveness calculations for state waiver programs.
- Clarification of eligibility criteria for medically needy and categorically needy individuals.
Main Results:
- Certain facilities must meet specific standards for waiver service provision.
- Revised cost-effectiveness equations are provided for state waiver programs.
- Clarification on the availability of services to both medically and categorically needy populations.
- Standardized treatment of post-eligibility income for recipients under a special income level.
Conclusions:
- Final regulations provide a framework for enhanced home and community-based services under Medicaid.
- The amendments aim to improve the efficiency and accessibility of waiver programs.
- These changes support the goal of enabling individuals to avoid institutionalization.