The U.S. Centers for Medicare and Medicaid Services (CMS) has revoked guidance related health-related social needs (HRSN) through Section 1115 waivers. Industry advocates say the move is indicative of the broader administration priorities to reduce Medicaid expenditures. Broadly, states use these programs to pay for health related social services, including meals and temporary housing. Damon […] The post CMS Rescinds Guidance For Medicaid’s Health-Related Social Needs appeared first on Home Health Care News.
The U.S. Centers for Medicare and Medicaid Services (CMS) has revoked guidance related health-related social needs (HRSN) through Section 1115 waivers. Industry advocates say the move is indicative of the broader administration priorities to reduce Medicaid expenditures.
Broadly, states use these programs to pay for health related social services, including meals and temporary housing.
Damon Terzaghi, senior director of Medicaid and home- and community-based services at the National Alliance for Care at Home, pointed out that individuals who utilize home and community-based services sometimes overlap with those who are in need of these social services.
“In fact, interviews with individuals across the country who help participants transition from institutions to the community consistently show that lack of affordable housing is one of the main barriers to such transitions,” he said in an emailed statement. “We also know how important nutrition is in maintaining healthy community living and preventing falls or other adverse outcomes. So while these SDOH/HRSN services are not specifically ‘home care,’ we do think that a decline in these supports will place more pressure on our provider members to meet the needs of the individuals they serve.”
In an informational bulletin, CMS said its pulling away November 2023 and December 2024 health-related social needs guidance.
“To evaluate policy options consistent with Medicaid and CHIP program requirements and objectives, CMS is rescinding the November 2023 and December 2024 CIBs,” the agency said in an informational bulletin. “CMS will consider states’ applications to cover these services and supports on a case-by-case basis to determine whether they satisfy federal requirements for approval under the applicable provisions of the Social Security Act and implementing federal regulations, without reference to the November 2023 and December 2024 CIBs or the HRSN Framework.”
CMS noted that it was dedicated to working with states to identify strategies that bolster improvement in Medicaid and CHIP.
Georgia Goodman, director of Medicaid policy at LeadingAge, called the latest move a demonstration of the current administration’s sentiment towards services delivered through Medicaid.
“This policy change is coming from the federal administration and signals a move away from supporting states in providing health-related social needs like supports with housing and tenancy support, nutrition services, and a broad array of similar health-adjacent services,” she told HHCN in an email. “Under the prior administration, guidance was released demonstrating a path forward in supporting individuals via Medicaid with things like first month’s rent, social services to support tenancy stability, nutritional counseling, and intensive mental health services to support more stable environments for individuals.”
Goodman believes that CMS may consider approvals for these kinds of services through Medicaid in the future, but that a more stringent review is likely.
“States that already have approved 1115 waivers that provide these services are not facing the elimination of the federal approval of these services though there could be challenges at the time of renewal,” she said.
Ultimately, Goodman was critical of the impact this would have on the individuals that rely on these services.
“This is a disturbing demonstration that the current administration prefers to limit access to services that keep people healthier, housed, and stable,” she said. “We continue to be concerned about administrative changes like this one that will limit access to services, independent of the threats posed through the congressional budget process.”
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