And Now for Some (Very Little) Good News
by Christina Medvescek
Medicaid benefits have made headlines this year for being in peril,
but two recent developments buck the trend ever so slightly.
At the moment and until the end of June 2004, money is actually flowing
into state Medicaid coffers. In addition, the federal government is
urging states to make it easier for people moving from nursing homes
back into the community to get durable medical equipment.
Extra Money
The first development refers to the Jobs and Growth Tax Relief Reconciliation
Act of 2003 the tax cut bill enacted in May. A major amendment greasing
the bills passage in the U.S. Senate was the provision of $20 billion
in state aid.
Half the funds can be used by states for "governmental purposes."
The other half, $10 billion, provides a temporary 2.95 percent boost
in federal Medicaid payments to states through June.
Joy Johnson Wilson, health policy director of the National Conference
of State Legislatures (NCSL), a Washington lobbyist group, says, "Most
states will use [the funds] to shore up their existing programs and
maintain them as best they can. Therell be plenty of competition
for the money where do you put it?" (For more on the State
Fiscal Assistance Provisions of the act, go to www.ncsl.org or call (202) 624-5400.)
Contact your state Medicaid office to get more information or offer
suggestions on usage of the temporary funds.
Durable Medical Equipment
The Centers for Medicare and Medicaid Services (CMS) recently encouraged
states to make it easier for people who use durable medical equipment
(DME) to move from an institution such as a nursing home back into
their homes and communities.
At present, people have to move home before applying for Medicaid
DME coverage. This has stymied those requiring hospital beds, lifts,
ventilators and other essential equipment who can neither go without
it nor pay for it themselves. In a letter to state Medicaid directors,
CMS clarified several "avenues" states could take to provide
such beneficiaries with necessary equipment before they leave the
institution.
"This information about obtaining DME through Medicaid is important
to many people that MDA serves," said Chris Rosa of Flushing,
N.Y., a member of the MDA National Task Force on Public Awareness
and MDAs Board of Directors. "For many people with neuromuscular
diseases, access to DME while they reside in institutions will eliminate
significant barriers to their successful transition to independent
living."
If youre hoping to get DME before leaving a nursing home, suggest
your state Medicaid office investigate one of these avenues: Ask vendors
to loan it for a trial period; have it purchased through the institution;
or use a Home and Community Based Services (HCBS) waiver, a Medicaid
program.
Its unclear how much impact this current expression of support will
have. The letter ends by reassuring financially beleaguered state
Medicaid programs that "although [DME] coverage is required under
Medicaid law, states are not required to purchase equipment needed
in the community prior to the persons discharge."
