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1 1 (May 26, 2021)

handle is hein.crs/govedli0001 and id is 1 raw text is: a n r e s i o a e e a h S r v c May 26, 2021 Medicaid's Money Follows the Person Rebalancing Demonstration Program Overview The Money Follows the Person (MFP) Rebalancing Demonstration Program (42 U.S.C. 1396a note) authorizes the Center for Medicare & Medicaid Services (CMS) to award competitive grants to states to transition Medicaid participants who reside in institutional settings that provide long-term services and supports (LTSS), such as nursing facilities, into community-based settings. MFP was designed to achieve the following objectives: Rebalancing: Increase the use of HCBS rather than institutional LTSS. Money follows the person: Eliminate barriers that restrict the use of Medicaid funds enabling eligible individuals to receive LTSS in the setting of their choice. Continuity of service: Increase the state Medicaid program's ability to provide Medicaid HCBS to eligible individuals who choose to transition. Quality assurance and quality improvement: Ensure procedures to provide quality assurance and continuous quality improvement for Medicaid HCBS. According to CMS, states have transitioned over 100,000 individuals to community living from 2008 to 2019. A total of 43 states and the District of Columbia have participated in MFP over the course of the program (Figure 1). Figure I. Medicaid Money Follows the Person (MFP) Demonstration States by Grant Award Year FMI4 CT DC DE MA N-1 NJ RI VT S me awarded SFP grnh i 201 2 S-e awarded VFPcran :, 2011 s that rcded their MFP ant award 4 MFPprogra instate Source: R. Coughlin et al., Money Follows the Person Demonstration: Overview of State Grantee Progress, Mathematica Policy Research, January to December 2016, September 2017. For more information, see CRS Report R43328, Medicaid Coverage of Long-Term Services and Supports. Relevant Legislation The MFP program was first enacted in 2006 and has been extended with additional mandatory funding over time. The Deficit Reduction Act of 2005 (DRA; P.L. 109- 171), Section 6071, established the MFP program and appropriated a total of $1.75 billion in funding from January 1, 2007, through September 30, 2011. The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended), Section 2403, amended the DRA to extend program funding for five years (from October 1, 2011, through September 30, 2016); it appropriated an additional $2.25 billion ($450 million for each fiscal year). It reduced the minimum stay requirements to be eligible from six months to 90 consecutive days in an inpatient facility. The Medicaid Extenders Act of 2019 (P.L. 116-3), Section 2, amended the DRA to extend program funding through September 31, 2019, after a lapse in annual appropriations since October 1, 2016; however, state grantees could expend any unspent FY2016 amounts through FY2020. It appropriated an additional $112.0 million for FY2019, of which $500,000 was for quality assurance, technical assistance, and oversight. The Medicaid Services Investment and Accountability Act of 2019 (P.L. 116-16), Section 5, amended the DRA to appropriate an additional $20.0 million for a total of $132.0 million for FY2019. The Sustaining Excellence in Medicaid Act of 2019 (P.L. 116-39), Section 4, amended the DRA to appropriate an additional $122.5 million, for a total of $254.5 million for FY2019. The Further Consolidated Appropriations Act, 2020 (P.L. 116-94), Division N, Section 205, amended the DRA to appropriate an additional $176.0 million for January 1, 2020, through May 22, 2020. The Coronavirus Aid, Relief, and Economic Security Act (CARES; P.L. 116-136), Division A, Section 3811, amended the DRA to extend program funding through November 30, 2020; it appropriated an additional $161.5 million for $337.5 million in total for January 1, 2020, through September 30, 2020, and a prorated amount based on FY2020 for October 1, 2020, through November 30, 2020 (extended through December 11 and 18, 2020, in P.L. 116-159 and in P.L. 116-215). tps:/crsreports.c S

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