This week the Government Accountability Office (GAO)
released a report on Medicaid in assisted living, entitled “Medicaid Assisted Living
Services: Improved Oversight of Beneficiary Health and Welfare Is Needed.” Generally
the report calls for better state reporting of critical incidents, with more
guidance and enforcement needed from the Centers for Medicaid and Medicare
Services (CMS) on exactly what information states must report. It does not call
for federal regulation of assisted living.
NCAL
stands ready to work with policymakers at the national and local levels on
strategies that strengthen the gathering of information on home and
community-based services, including those in provided in assisted living
communities. Appropriate safeguards are necessary to ensure high quality care,
and that with better data, we can better understand Medicaid’s impact.
The
report explains how states and CMS oversee home and community-based services
(HCBS) waiver programs, specifically for coverage of services in assisted
living communities. It also provides descriptive statistics on the
state-reported number of Medicaid beneficiaries receiving services in AL and
Medicaid spending on these beneficiaries.
GAO’s
findings acknowledged CMS’ progress to improve oversight of health and welfare
of beneficiaries receiving services covered by an HCBS waiver, but concluded
that more needs to be done. The agency made three recommendations to CMS:
- Provide guidance and clarify requirements regarding the
monitoring and reporting of deficiencies that states using HCBS waivers
are required to report on their annual reports.
- Establish standard Medicaid reporting requirements for
all states to annually report key information on critical incidents,
considering, at a minimum, the type of critical incidents involving
Medicaid beneficiaries, and the type of residential facilities, including
assisted living facilities, where critical incidents occurred.
- Ensure that all states submit annual reports for HCBS
waivers on time as required.
NCAL
will be meeting with the offices of the four senators who requested the
work—Senators Collins, McCaskill, Hatch, and Warren—as well as CMS to discuss
next steps.
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