One of the most important protections for the spouses of Medicaid applicants is the "community spouse resource allowance...Read more
Report Criticizes Lax Oversight of Medicaid Waiver Programs
- July 19th, 2003
The Bush administration has allowed states to make sweeping changes in the way care is delivered to elderly and disabled Medicaid recipients but has failed to monitor the quality of that care, according to a Congressional investigative report. The upshot is that some Medicaid patients are being neglected medically and physically, the New York Times reports.
The administration often boasts that it has approved record numbers of Medicaid "waivers," which exempt states from some federal regulations and give them wide latitude in changing Medicaid-covered services, including replacing nursing home care with so-called "home and community-based care."
But a report by the General Accounting Office (GAO) says that the Centers for Medicare and Medicaid Services (CMS) has not been monitoring the quality of care delivered under such waivers, as called for by law.
The GAO examined services provided to elderly people in 15 states where rather than pay the high cost of nursing home care, the states promised to provide a wide range of social and medical services in the patient''s home or community.
The GAO found problems with the quality of care in 11 of the 15 state waiver programs it examined. In many cases, Medicaid beneficiaries simply did not receive the services they were supposed to receive, and researchers found "medical and physical neglect" of some Medicaid recipients. But the "full extent" of the problem is unknown because "no one was enforcing basic safety and hygiene standards or systematically reviewing patients'' records," the Times reports. More than half the people receiving home and community care under Medicaid waivers are 65 or older.
"The report confirms what many Medicaid advocates have expressed as their major concern with the rush on the part of CMS to grant states waivers '” that the waivers are far more focused on saving money than improving, or even stabilizing, the health of the beneficiaries," says the National Senior Citizens Law Center.
"These waivers should be put on hold until the department gets a handle on the quality of care going to older and disabled Americans," said Sen. Charles E. Grassley (R-Iowa), who had requested the study. "Right now there''s no accountability, and that''s wrong."
To download the GAO report, "Federal Oversight of Growing Medicaid Home and Community-Based Waivers Should Be Strengthened" (GAO-03-576), in PDF, click on: http://www.gao.gov/new.items/d03576.pdf (If you do not have the free PDF reader installed on your computer, download it here.)
To read the full text of the article in the New York Times, click on: http://www.nytimes.com/2003/07/07/politics/07MEDI.html?hp (Free registration required and article will be only temporarily available for free.)
Following the article, the Times published an editorial, "Is Home Care Really Working?", on the problem. To read this, click on: http://www.nytimes.com/2003/07/08/opinion/08TUE1.html (Free registration required and article will be only temporarily available for free.)
Local Elder Law Attorneys in Ashburn, VA
Needham Mitnick & Pollack, PLC
Susan Pollack served as Chairperson of the Falls Church Senior Citizens Commission from 1997 to 2011 and was on the Executive Board of the Falls Church Education Foundation. She has also served on the Board of Directors of the Alzheimer’s Association of the National Capital Area and is a member of the Arlington B...
Ron M. Landsman, P.A.
Ron M. Landsman has been practicing elder law since 1983, before it was known as elder law, originally with Landsman and Laster, Washington, D.C., then Landsman, Eakes and Laster, also in Arlington, VA, and since 1990 in his own practice in Montgomery County, Maryland. He has been among the most active members of the...