At the annual HCBS conference in 2021, one topic continued to come up repeatedly: time.
At the crux of the issue was the relatively short timeframe for when new federal investments in home- and community-based services needed to be spent. With the time required to formulate and get approval on spending proposals both at the state and federal level, many state Medicaid agency staff members voiced concerns that there simply wasn’t enough time to spend these much-needed funds for Medicaid services expansion following the COVID-19 pandemic.
In the months following the annual meeting, states continued to question the limited time they had to spend the funding allocated in the American Rescue Plan Act (ARPA), which passed in March 2021. According to the law, states would receive a one-time 10 percent enhanced Federal Medical Assistance Percentage (FMAP) reimbursement – an estimated $12.67 billion nationwide – that had to be used by March 2024.
The Centers for Medicare and Medicaid Services (CMS) adjusted the spending deadline for the ARPA funds in early June. Now, state Medicaid offices have until March 2025 to seek plan approval and spend the ARPA investment.
“With this extension, we are addressing states’ concerns, giving states the time and resources to strengthen connections to care at home and in communities,” said CMS Administrator Chiquita Brooks-LaSure in a press release announcing the extension.
The agency noted in the release that with more time to plan for, seek approval on and implement the plans for the funds, states can enhance high-quality, cost-effective, person-centered services for Medicaid members. The CMS hopes these investments help more aging populations and those with disabilities live and thrive in home settings that keep them in their communities.
This enhanced FMAP was the largest federal investment in HCBS in more than 10 years. Federal guidelines stipulate states can use the investment to enhance HCBS activities, increase eligibility, strengthen oversight and accelerate long-term services and supports (LTSS) reform and innovation. Some key priorities outlined by the CMS included expanding services, investing in caregiver support, enhancing provider training/certification and health information technology initiatives. The law specifies funding must be used to “implement, or supplement the implementation of, one or more activities to enhance, expand, or strengthen” Medicaid HCBS. As the law stands, this financial bump will only come once – so there is pressure to leverage and maximize this increase to its full potential. The amount flowing to each state will vary because, as previously noted, this is an increase in a federal matching rate by 10 percentage points, which is unique to individual states.
How Health IT Investments Benefit HCBS
Thanks to the influx in funds for HCBS investment, states now can invest in upgrading health information technology infrastructure that assists in the delivery of health and human services. With the right comprehensive tools, Medicaid agencies can streamline:
- Wait list reduction/management
- Information technology implementation
- Incident management
- Systems assessments
- Telehealth implementation and support
- HCBS quality improvement
For more than 20 years, FEI Systems has successfully demonstrated our commitment to assisting state agencies in doing those very things. We specialize in the coordination and delivery of barrier-free, person-centered care that promotes optimal health and well-being for all people. Our enterprise-level, comprehensive case management solutions and health IT services currently support HCBS populations within Medicaid Waiver and State Plan programs and we welcome the opportunity to assist you in addressing the identified priorities outlined by the CMS.
