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Several recent legislative efforts in Congress have included proposals that would cap the federal contribution (overall in a block grant or per person in a per capita cap) to Medicaid.
Providers of long-term services and supports (LTSS) cannot ensure high-quality services without sufficient funding.
Medicaid coverage of long-term services and supports (LTSS) provides a safety net for vulnerable older people—and younger people with disabilities—who have low incomes and few assets.
Under current Medicaid financial eligibility rules, individuals may not have more than $2,000 in assets. In addition, long-term care insurance (LTCI) is difficult to obtain.
Medicaid is the single largest public funding source for long-term services and supports (LTSS). It is a combined federal-state program. Some Medicaid services are federally mandated.
Federal law and regulations specify the general eligibility and coverage requirements for mandatory and optional Medicaid long-term services and supports (LTSS).
Many chronic illnesses and other health conditions—such as heart disease, cancer, multiple sclerosis, arthritis, diabetes, and emphysema—can result in functional limitations.
Many states are enrolling Medicaid participants in capitated, risk-based managed care plans designed to coordinate all their care, including long-term services and supports (LTSS) if needed.
Government and providers of long-term services and supports (LTSS) use various approaches to promote service quality and protect consumer rights.
Nursing facilities provide long-term services and supports (LTSS), as well as short-term rehabilitation and postacute care following hospitalizations to people of all ages.