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HRD-92-44R 1 (1992-09-25)

handle is hein.gao/gaobackdq0001 and id is 1 raw text is: GAO United States General Accounting Office Washington, D.C. 20548 Human Resources Division B-249868 September 25, 1992 The Honorable John D. Dingell Chairman, Committee on Energy and Commerce House of Representatives Dear Mr. Chairman: This letter responds to your request for a review of fiscal and other implications of the long-term care (LTC) insurance projects sponsored by the Robert Wood Johnson (RWJ) Foundation. The Foundation sponsors projects that link private LTC insurance with the Medicaid program in four states. We agreed to provide information on (1) the basis for the Department of Health and Human Services' (HHS) approval of amendments to several Medicaid state plans that allow those states to implement these LTC insurance projects, (2) the financial implications for the federal government of using section 1902(r)(2) of the Social Security Act as the basis for approving these projects, and (3) the federal role in protecting consumers who purchase LTC insurance policies through the RWJ projects.1 You expressed concern about the extent of federal oversight for these projects because they were approved as Medicaid state plan amendments rather than as demonstration projects. With demonstration projects, HHS has authority to impose restrictions and to exert substantial oversight. With state plan amendments, however, HHS has limited authority to impose restrictions or exert oversight, as long as the state 'Medicaid is an entitlement program that provides medical assistance to certain low-income people. To qualify for Medicaid, people usually must meet income and asset criteria that are linked to eligibility criteria for the cash assistance programs, Aid to Families With Dependent Children and Supplemental Security Income. Section 1902(r)(2) allows states to compute income and resources in a manner that is less restrictive than these cash assistance programs require. GAO/HRD-92-44R, LTC Insurance Partnerships

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