State Information and Statistics
Demographics
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State Affiliation
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State Population (2011)
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Uninsured Population (FY2010)
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Total Medicaid Enrollment (FY2008)
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MC Enrollment (FY2011)
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CHIP Enrollment (FY2010)
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Connecticut
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3,529,100
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320,133
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552,100
|
571,020
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21,033
|
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Maine
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1,311,400
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133,065
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350,100
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267,012
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32,994
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Massachusetts
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6,526,500
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285,717
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1,521,800
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1,067,929
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142,279
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New Hampshire
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1,298,400
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145,013
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147,500
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221,168
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10,630
|
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Rhode Island
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1,036,800
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126,184
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194,600
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183,433
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23,253
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Vermont
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620,000
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49,880
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167,500
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112,831
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7,026
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Notes: Percentages may not sum to 100% due to rounding effects. For more details, see "Notes to Topics Based on the Current Population Survey (CPS)" at http://www.statehealthfacts.kff.org/methodology. Population and demographic data on are based on analysis of the Census Bureau’s March 2011 and 2012 Current Population Surveys (CPS; Annual Social and Economic Supplements) and may differ from other population estimates published yearly by the Census Bureau. U.S. and state population data displayed on this site are restricted to the non-institutionalized, civilian (not active duty military) population; state data represent 2-year averages.
Sources: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2011 and 2012 Current Population Survey (CPS: Annual Social and Economic Supplements). U.S. Census Bureau, 2010 American Community Survey, Table S2701, available at: http://www.census.gov/hhes/www/hlthins/data/acs/aff-2010.html
Spending
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State Affiliation
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Federal Matching Rate FY2012
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Medicaid Payments Per Enrollee FY2008
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Spending on Acute Care FY2009
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Spending on Long Term Care FY2009
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Average Annual Growth in Medicaid Spending (2007-2009)
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Connecticut
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50.00%
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$7,442
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$2,379,225,894
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$3,333,013,744
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17.8%
|
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Maine
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63.27%
|
$6,292
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$1,690,381,633
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$776,152,002
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12.4%
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Massachusetts
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50.00%
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$7,020
|
$8,820,234,886
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$3,660,409,543
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10.1%
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New Hampshire
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50.00%
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$7,086
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$523,403,426
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$572,468,950
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6.7%
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Rhode Island
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52.12%
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$8,208
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$1,194,365,473
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$576,629,934
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4.7%
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Vermont
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57.58%
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$5,785
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$546,291,968
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$391,992,978
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3.8%
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Sources: Urban Institute and Kaiser Commission on Medicaid
Notes: FY2012: Effective from October 1, 2011 to September 30, 2012
Duals (Medicare)
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State Affiliation
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Duals Eligible Enrollment (2007)
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Duals as a % of Aged & Disabled Medicaid Enrollees (2007)
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Spending per Dual Eligibility Long-Term Care (2007)
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State Medicaid Spending on Prescribed Drugs (2007)
(In Millions)
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*Annual Payments based on Revised NHE (2006)
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|
Connecticut
|
100,257
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75%
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$1,970
|
37
|
$112,079,205
|
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Maine
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88,600
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76%
|
$626
|
11
|
$40,889,787
|
|
Massachusetts
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250,744
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43%
|
$2,865
|
37
|
$216,797,916
|
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New Hampshire
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27,773
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74%
|
$408
|
4
|
$27,632,378
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Rhode Island
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39,236
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60%
|
$516
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6
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$37,654,242
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Vermont
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31,217
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75%
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$335
|
10
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$16,672,538
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*Notes: These are original and revised annual state "clawback" payments from CMS based on December 2005 actual enrollment of Medicaid and Medicare dual eligibles. They represent the payment amounts that states will be assessed to finance a portion of Medicare Part D for each dual eligible during 2006. The newly updated National Health Expenditures (NHE) growth rate in per capita prescription drug spending between 2003 and 2006 was used by CMS in the calculation of the new clawback figures. The total percentage reduction in annual payments is -9.66%. For more details about the Clawback, see KCMU''s "The ''Clawback:'' State Financing of Medicare Drug Coverage," available at http://www.kff.org/medicaid/7118a.cfm.
Sources: Urban Institute estimates based on data from the Medicaid Statistical Information System (MSIS) and Medicaid Financial Management Reports (CMS Form 64) prepared for the Kaiser Commission on Medicaid and the Uninsured. Available at: http://www.kff.org/medicaid/7846.cfm.
An Update on the Clawback: Revised Health Spending Data Change State Financial Obligations for the New Medicare Drug Benefit, Table 2, Kaiser Commission on Medicaid and the Uninsured (KCMU), March 2006. Available at http://www.kff.org/medicaid/7481.cfm.
Definitions
Dual Eligibles are individuals entitled to Medicare who are also eligible for some level of Medicaid benefits.
CMS: The Centers for Medicare and Medicaid Services
Clawback: The mechanism through which the states will help finance the new Medicare drug benefit is commonly referred to as the "clawback," the statutory term for which is "phased-down state contribution."
NHE: The National Health Expenditures growth rate in per capita prescripton drug spending between 2003 and 2006 is used to calculate the state contribution for dual eligibles in Medicare Part D. For details about the NHE from CMS, see http://www.cms.hhs.gov/NationalHealthExpendData/".
KCMU: The Kaiser Commission on Medicaid and the Uninsured
MMIS Procurement (As of April 27, 2012)
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State Affiliation
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MMIS Vendor
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MMIS Status
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Medicaid Procurement Website
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Connecticut
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Current - HP Enterprise Svcs (current contract ends 10/01/2014 with an additional three 1-year extension )*
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Current - HP Enterprise Svcs
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Connecticut
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|
|
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Maine
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Current - Molina Information Sysems (MMIS) through 12/31/14
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Current - Molina Information Systems
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Maine
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|
|
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Massachusetts
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State Operated (5/25/05 -3/1/11)
Contract end with option years(6/1/15)*
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Current - State Operated
Option years 4
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Massachusetts
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|
|
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New Hampshire
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Current -HP Enterprise Svcs (current contract extension through 7/01/12)*
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Current - HP Enterprise Svcs
* 23-month contract ext
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New Hampshire
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|
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Rhode Island
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Current - HP Enterprise Svcs (current contract through 6/30/09 with 2 option years)*
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Current - HP Enterprise Svcs
Update pending
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Rhode Island
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|
|
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Vermont
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Current-HP Enterprise Svcs (current contract ends 12/31/08 with 3 option years)*
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Current - HP Enterprise Svcs
MMIS RFP issueded December 2010 Update pending
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Vermont
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|
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*Sources: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Data-and-Systems/Downloads/MMISFACSR.pdf
Waivers
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State Affiliation
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MR/MD (2007)
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Aged (2007)
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Aged & Disabled (2007)
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Physically Disabled (2007)
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Children
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Connecticut
|
234
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N/A
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12,587
|
741
|
N/A
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Maine
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2,750
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N/A
|
1,300
|
186
|
N/A
|
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Massachusetts
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11,978
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8,934
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N/A
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N/A
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N/A
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New Hampshire
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2,651
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3,128
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N/A
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N/A
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N/A
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Rhode Island
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3,394
|
946
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2,279
|
120
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N/A
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Vermont
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N/A
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N/A
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N/A
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N/A
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N/A
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Waivers (continued)
Sources: The Kaiser Commission on Medicaid and the Uninsured (KCMU) and The University of California at San Francisco's (UCSF) analysis based on The Centers for Medicare & Medicaid Services (CMS) Form 372, December 2009, Table 5. "Medicaid 1915(c) Home and Community-Based Service Programs: Data Update" available at http://www.kff.org/medicaid/7720.cfm.
Definitions
N/A: No waiver offered. 1915(c) Home and Community-Based Service
Waiver: Serves as one of three main ways a state can provide Medicaid home and community-based services. The other two are Personal Care Services and the Home Health Benefit.
MR/DD: Mental Retardation and Developmental Disabilities
TBI/SCI: Traumatic Brain and Spinal Cord Injury
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NESCSO Project Highlights
As we approach the conclusion of the Early Innovator Grant and as the participating states are well underway with the development and implementation for their states approach to health insurance exchanges, the NESCSO/NESCIES Team is beginning to transition from our regular activities (e.g., bi-monthly conference calls, e-news) to serving as a resource for collaborative efforts between the New England states. We have developed a resource guide for you to be able to contact your colleagues in the other states to discuss questions or issues that may arise during the final months leading to October 2013.
Follow the link to the Health Insurance Exchange - New England Directory of Key Staff: NESCIES Contact Guide February 2013
For additional information, please contact Brenda Harvey at brenda.harvey@umassmed.edu.
The New England States Consortium Systems Organization (NESCSO) is developing a regional data warehouse to provide New England states the ability to conduct timely comparative analyses for the effective and efficient administration of the states’ Medicaid State Plans and to support the regional initiatives of the NESCSO members. Click here for more information.
New England State Links
CMS/HIX Updates
CMS has released the business service definition (BSD) to be used by the Federally-facilitated Exchange for the Determine Medicaid and Tax Households Business Service Definition for posting on CALT. This BSD defines the individual’s Medicaid and Tax Household when an application for insurance affordability programs is submitted to the Exchange. This business service includes implementation of rules to achieve the following results:
- Each tax filer’s Tax Household, using data for the appropriate coverage year(s).
- Each applicant’s Medicaid Household, based upon Tax Household, tax filing status and other family information for the appropriate coverage year.
- Guidance and exception messages when a Medicaid or Tax Household cannot be determined for the applicant.
The BSD can be found with other FFE Eligibility/MAGI BSDs in the Exchange Eligibility and Enrollment Guidance folder in CALT.
The intended audience for this BSD includes state business, technical, governance, and project management stakeholders. Specific users should include software or system developers and testers.
Web Resources
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