Click hereClick here to read the 1/5/2017 CMS guidance on State Medicaid agency managed care plan arrangements’ responsibility to ensure that Medicaid enrollees under 21 years old have access to the full scope of federally mandated EPSDT services. The memo notes that states may opt to “carve out” certain EPSDT services and reimburse them, separately from managed care arrangements, on a fee-for-service basis – which some states do with IEP-required services provided by schools.
This fact sheet from the Kaiser Family Foundation examines key questions around the potential changes President-elect Donald Trump and the next Congress may seek to make in Medicaid. It considers multiple forms a repeal of the ACA could assume and potential structural changes to Medicaid, including through a block grant or a per capita cap. It also reflects on the impact such a repeal could have on coverage, financing, delivery system and payment reform, and access to care, particularly for complex and vulnerable populations. The fact sheet also discusses how executive powers can be used to make changes to Medicaid without congressional action, including new regulations and Medicaid waivers.