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Waiving certain provisions of the Medicare and Medicaid statutes is appropriate and even desirable under some circumstances.
The federal government must ensure that the entitlement nature of Medicaid applies to expansion populations.
Federal and state governments must comply with the transparency requirements established by the Affordable Care Act (ACA).
The federal government should not allow states to impose or enforce greater than nominal Medicaid premium- and cost-sharing on Medicaid beneficiaries.
Federal and state governments must ensure that waivers cover all mandatory Medicaid services in the same amount, duration, and scope for all eligible beneficiaries.
Federal and state governments should ensure that expansion populations have adequate access to the same or comparable provider networks as those available to non-expansion populations.
Receipt of Medicaid should not be conditioned upon compliance with work requirements or personal incentive programs.
Federal and state governments must ensure that existing Medicare and Medicaid waiver authority is used to integrate health care and LTSS under the following conditions.
The federal government should require states to demonstrate the ability to conduct robust outreach and education when using waiver authority to enroll individuals eligible for the ACA Medicaid expa
Quality assurance standards should include, at a minimum, internal and external quality review, meaningful grievance and appeals procedures, robust state monitoring and oversight (e.g., by an ombud