At the Center for Community Solutions’ work, Medicaid is an important policy area that we continue to follow. It is a complex legal framework, authorized by Title XIX of the Social Security Act. Since Medicaid was signed into law in 1965, major components of the program have evolved. So, we have created a timeline to look back at the evolution of a program that continues to provide care to millions of Americans annually.
Medicaid is an important policy area that we continue to follow.
Since implementation in 1967, the Early and Periodic Screening, Diagnostic, and Treatment has expanded focus to even more preventive services. At the time of implementation, EPSDT services were described as “the only hope of preventive or primary health care” for American children living in households “too poor to pay for checkups.” This was before Medicaid coverage for women and infants who were at or above 100 percent of the federal poverty level in 1981 and even before the creation of the State Children’s Health Insurance program in 1997 that expanded coverage for children’s health services.
Later, children’s health services would be expanded to include families up to 133 percent FPL and Medicaid coverage would be extended to children from ages 6 through 18 under 100 percent FPL.
The newest federal rules proposals for Managed Care and Access
According to the Centers for Medicare and Medicaid Services (CMS), a "proposed rule" announces CMS' intent to issue a new regulation or change an existing regulation. These new rules are the result of proposed rules that were open for public comment and later finalized.
The Center for Community Solutions will continue to follow the new federal rules through implementation.
In April 2024, the Centers for Medicaid and Medicare Services finalized rules for Managed Care and Access. The Managed Care Final Rule is focused on transforming the managed care delivery system. According to CMS, managed care is a health care delivery system organized to manage cost, use, and quality. The Access Final Rule focuses on the Fee-for-Service (FFS) delivery system and the Home and Community-Based Services Delivery Systems.
Home and Community-Based Services (HCBS) provides services to help people who need a little extra help to remain in their homes, as opposed to in a nursing home or other long-term care facility. States can opt-into providing other services outside of home health services.
The Center for Community Solutions will continue to follow the new federal rules through implementation. In this series, our articles will detail each new rule, what has changed, and when implementation will occur.
