HHS Announces New Guidance to Strengthen Medicaid
On Jan. 4, the United States Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced via a press release that it has released guidance on an opportunity for states to address health-related social needs for people with Medicaid coverage through the use of “in lieu of services and settings” in Medicaid managed care. The new option helps states offer alternative benefits for health-related social needs like housing instability, food insecurity, to help enrollees maintain coverage, and to improve health outcomes.
The guidance comes in the form of a letter from the state Medicaid director and can be accessed here.
On Dec. 20, we reported that health-related social need services in 1115 demonstration programs can include housing supports, nutrition supports, and case management.
The press release states that “This announcement supports the Biden-Harris Administration’s goal to end hunger and reduce diet-related diseases by 2030 – all while reducing disparities – and its corresponding National Strategy on Hunger, Nutrition, and Health. For example, under today’s guidance, states may adopt in lieu of services and settings to offer medically appropriate, cost-effective tailored meals for people with severe, chronic health conditions made worse by poor diet, living in “food deserts,” or not having access to nutritious food choices.”
Additionally, the letter lays out the requirements and guardrails states are required to meet to ensure that the new innovations are cost effective, medically appropriate, preserves enrollee rights and protections, and fulfills the objectives of the Medicaid program. The requirements, according to the press release, allow CMS to ensure appropriate oversight and provide additional guidance to states on how to evaluate and monitor the impact of these in lieu of services and settings.
HHS Secretary Xavier Becerra was quoted in the release saying that “We are deeply committed to strengthening Medicaid for the millions of Americans covered by it. Today’s step ensures people with Medicaid receive the broader care they need to live safe and healthy lives. We call on all states to leverage these innovative options and stand ready to partner with them in providing essential health care services.”
CMS Administrator Chiquita Brooks-LaSure was also quoted in the release saying that “In partnership with CMS, states have been working hard to better meet the health-related social needs of people with Medicaid coverage. Today’s announcement is the next step in CMS’ effort to use every lever available to protect and expand coverage for all eligible individuals as we work with our state partners to offer whole-person care.”
