Policy Update

HHS Grants Aim to Encourage Home Care

Recently, the United States Department of Health and Human Services announced a five-year program to encourage states to allow Medicaid beneficiaries to reside in their homes or communities, rather than in nursing homes. Because the cost of home or community care is usually less than institutional care, the arrangement should be less expensive than the current system in the long run.

But to facilitate and encourage change, the program will for one year provide a higher rate of federal Medicaid matching funds (between 75 and 90 percent) for beneficiaries that states move from nursing homes back into their communities. Participating states must agree to continue to provide home and community care to these beneficiaries for at least one additional year after the temporary rate increase. Read More

Hot Weather Protocols in Place for Nursing Homes and Care Facilities

In the midst of last month's heat wave, which claimed more than 130 lives, Governor Arnold Schwarzenegger made efforts to ensure the safety of California's institutionalized residents. On two separate occasions, he directed the Department of Health Services to contact each residential care facility or nursing home to ensure they have the proper procedures in place for evacuation and emergency situations.

The governor also instructed the Department of Social Services to coordinate In-Home Supportive Services (IHSS) workers with county public health officers and welfare directors to proceed with onsite safety inspections for all state residents living in single-room occupancy hotels. Read More

State Officials Propose Mandatory Prescription Drug Discounts

The Schwarzenegger administration has proposed requiring pharmaceutical companies to provide discounts to uninsured families with incomes under $60,000 per year, and to families with incomes up to $68,700 if they require catastrophic medical care and have out-of-pocket medical expenses in excess of 10 percent of their income. The plan, which could provide discounts for five million Californians, would be enforced by cutting off companies from Medi-Cal money if they do not comply within five years.

Democrats in the California legislature have introduced similar legislation that would require compliance from companies within three years. Governor Schwarzenegger has made it known that he will not sign the legislation as it stands, and favors his own plan. The debate continues, but it appears that uninsured families will eventually get their discounts, one way or another. Read More

Wealthier Seniors Will Pay Higher Premiums for Medicare

Medicare Part D—the new prescription drug benefit offered to seniors in the Medicare program—has received a lot of media attention lately. But some wealthier seniors may be surprised next year when their premiums spike due to some less-spoken-about changes in Part B of the plan, which covers care such as doctor visits, medical tests, and physical therapy.

Throughout the history of the program, Medicare recipients have never before been "means-tested." But seniors with an adjusted gross income exceeding $80,000 will now pay more than those with lower incomes, and those who make more than $200,000 a year will see their premiums double. These income-based premiums will apply to 1.5 to 2 million Medicare beneficiaries next year.

While some welcome the changes as progressive, others fear it could undermine the Medicare system, as wealthier seniors turn to private insurance options to avoid the hefty fees. Read More

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