NSCLC Requests Clarification on CMS Policy on Medicaid HCBS Waiver

The District of Columbia operates a Medicaid home and community-based services waiver for individuals 65 years old or older or with disabilities. The waiver document it submitted to the Centers for Medicare & Medicaid Services (CMS), and for which it received approval, indicates that the “medically needy” are a covered eligibility category. However, DC advocates were recently informed by DC Medicaid officials that individuals with incomes over the “special income category” limit (300% of the Supplemental Security Income’s federal benefit rate) could not qualify for the waiver unless they established income trusts. Several organizations, including NSCLC, signed a letter directed to CMS asking that the agency clarify whether DC is required to provide coverage for medically needy individuals, and, if not, whether alternative methods are available for eligibility. Read letter.