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Home and Community-Based Services waivers (HCBS waivers) or Section 1915(c) waivers, 42 U.S.C. Ch. 7, § 1396n §§ 1915(c), are a type of Medicaid waiver. HCBS waivers expand the types of settings in which people can receive comprehensive long-term care under Medicaid.
Operating ICFs/IID certified companies and organizations must recognize the developmental, cognitive, social, physical, and behavioral needs of individuals with intellectual disabilities who live in their setting or environment by requiring that each individual receives active treatment in regards to appropriate habilitation of their functions to be eligible for Medicaid funding. [6]
The change in terminology was implemented after the Centers for Medicaid and Medicare Services (CMS) [2] modified the State Operations Manual Appendix J - Guidance to Surveyors: Intermediate Care Facilities for Individuals with Intellectual Disabilities [3] The changes were implemented after President Obama signed Rosa's Law.
Kerr previously served as director of health agency from 2003 through 2007 and worked for the agency for 22 years prior to this latest stint as the agency director.
A variety of different types of health plans serve Medicaid managed care programs, including for-profit and not-for-profit, Medicaid-focused and commercial, independent and owned by health care providers such as community health centers. In 2007, 350 health plans offered Medicaid coverage.
Medicaid is the largest revenue source for FQHCs, but Medicare offers financial incentives, such as higher per-visit fees compared to non-FQHC providers, making FQHC status attractive. Under the Affordable Care Act, Medicare transitioned to a Prospective Payment System (PPS) in 2014, offering additional payments for preventive services and new ...
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