When is carer supplement in 2011

Within broad federal guidelines and certain limitations, states determine the amount and duration of services offered under their Medicaid programs. States may limit, for example, the number of days of hospital care or the number of physician visits covered.

Two restrictions apply: 1 limits must result in a sufficient level of services to reasonably achieve the purpose of the benefits, and 2 limits on benefits may not discriminate among beneficiaries based on medical diagnosis or condition. In general, states are required to provide comparable amounts, duration, and scope of services to all categorically needy and categorically related eligible persons.

There are two important exceptions: 1 medically necessary health care services that are identified under the EPSDT program for eligible children, and that are within the scope of mandatory or optional services under federal law, must be covered even if those services are not included as part of the covered services in that state's plan, and 2 states may request waivers to pay for otherwise uncovered home and community-based services for Medicaid-eligible persons who might otherwise be institutionalized.

As long as the services are cost effective, states have few limitations on the services that may be covered under these waivers except that states may not provide room and board for the beneficiaries, other than as a part of respite care. With certain exceptions, a state's Medicaid program must allow beneficiaries to have some informed choices among participating providers of health care and to receive quality care that is appropriate and timely.

Medicaid operates as a vendor payment program. States may pay health care providers directly on a fee-for-service basis, or states may pay for Medicaid services through various prepayment arrangements, such as health maintenance organizations HMO s. Within federally imposed upper limits and specific restrictions, each state for the most part has broad discretion in determining the payment methodology and payment rate for services.

Generally, payment rates must be sufficient to enlist enough providers so that covered services are available at least to the extent that comparable care and services are available to the general population within that geographic area. Providers participating in Medicaid must accept Medicaid payment rates as payment in full. From to , excessive and inappropriate use of the DSH adjustment resulted in rapidly increasing federal expenditures for Medicaid. Legislation passed in and , and amended in the BBA of and later legislation, capped the federal share of payments to DSH hospitals.

States may impose nominal deductibles, coinsurance, or copayments on some Medicaid beneficiaries for certain services. The following Medicaid beneficiaries, however, must be excluded from cost sharing: pregnant women, children under age 18, and hospital or nursing home patients who are expected to contribute most of their income to institutional care.

In addition, all Medicaid beneficiaries must be exempt from copayments for emergency services and family planning services. Under the DRA , new cost sharing and benefit rules provided states the option of imposing new premiums and increased cost sharing on all Medicaid beneficiaries except for those mentioned above and for terminally ill patients in hospice care.

The DRA also established special rules for cost sharing for prescription drugs and for nonemergency services furnished in emergency rooms. The federal government pays a share of the medical assistance expenditures under each state's Medicaid program. That share, known as the Federal Medical Assistance Percentage FMAP , is determined annually by a formula that compares the state's average per capita income level with the national income average.

States with a higher per capita income level are reimbursed a smaller share of their costs. By law, the FMAP cannot be lower than 50 percent or higher than 83 percent. In fiscal year , the FMAP s varied from 50 percent in 13 states and the territories to The American Recovery and Reinvestment Act ARRA of Public Law provided states with an increase in their Medicaid FMAP s of up to 14 percentage points, depending on state unemployment rates, for the first quarter of fiscal year through the first quarter of fiscal year Section of Public Law referred to as the Education, Jobs, and Medicaid Assistance Act of extended these increases for the second and third quarters of fiscal year , but at lower levels than those under ARRA.

The federal government also reimburses states for percent of the cost of services provided to American Indians and Alaska Natives through facilities of the Indian Health Service, for percent of the cost of the Qualifying Individuals QI program described later , and for 90 percent of the cost of family planning services, and shares in each state's expenditures for the administration of the Medicaid program. Most administrative costs are matched at 50 percent, although higher percentages are paid for certain activities and functions, such as development of mechanized claims processing systems.

Rather, the federal government matches at FMAP rates state expenditures for the mandatory services, as well as for the optional services that the individual state decides to cover for eligible beneficiaries, and matches at the appropriate administrative rate all necessary and proper administrative costs. Medicaid was initially formulated as a medical care extension of federally funded programs providing cash income assistance for the poor, with an emphasis on dependent children and their mothers, the disabled, and the elderly.

Over the years, however, Medicaid eligibility has been incrementally expanded beyond its original ties with eligibility for cash programs. Legislation in the late s extended Medicaid coverage to a larger number of low-income pregnant women and poor children and to some Medicare beneficiaries who are not eligible for any cash assistance program. Legislative changes also focused on increased access, better quality of care, specific benefits, enhanced outreach programs, and fewer limits on services.

In most years since its inception, Medicaid has had very rapid growth in expenditures. This rapid growth has been due primarily to the following factors:. As with all health insurance programs, most Medicaid beneficiaries incur relatively small average expenditures per person each year, and a relatively small proportion incurs very large costs.

Moreover, the average cost varies substantially by type of beneficiary. National data for , for example, indicate that Medicaid payments for services for Similarly, for However, other groups had much larger per-person expenditures. Medicaid payments for services for 4.

When expenditures for these high- and lower-cost beneficiaries are combined, the payments to health care vendors for Long-term care is an important provision of Medicaid that will be increasingly utilized as our nation's population ages. The Medicaid program paid for nearly 41 percent of the total cost of nursing facility care in With the percentage of our population who are elderly or disabled increasing faster than that of the younger groups, the need for long-term care is expected to increase.

Another significant development in Medicaid is the growth in managed care as an alternative service delivery concept different from the traditional fee-for-service system. Under managed care systems, HMO s, prepaid health plans PHP s , or comparable entities agree to provide a specific set of services to Medicaid enrollees, usually in return for a predetermined periodic payment per enrollee.

Managed care programs seek to enhance access to quality care in a cost-effective manner. Waivers may provide the states with greater flexibility in the design and implementation of their Medicaid managed care programs. Waiver authority under sections b and of the Social Security Act is an important part of the Medicaid program.

Section b waivers allow states to develop innovative health care delivery or reimbursement systems. Section waivers allow experimental statewide health care reform demonstrations to cover uninsured populations and to test new delivery systems without increasing costs. Finally, the BBA provided states a new option to use managed care without a waiver.

According to the Medicaid Managed Care Enrollment Report, the share of Medicaid beneficiaries enrolled in some form of managed care program grew steadily from CHIP is currently funded only through fiscal year Carer's Allowance Supplement is an extra payment for people in Scotland who get Carer's Allowance on a particular date.

The first payment was on 16 June. There is an extra payment due to coronavirus. Find out more about the Coronavirus Carer's Allowance Supplement. If you're due to get a payment, you'll get a letter from Social Security Scotland before the payment is made. Find out more about how Social Security Scotland will use your data. Note: Your feedback will help us make improvements on this site.

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Home News. Published: 07 Oct Part of: Health and social care , Communities and third sector , Equality and rights. Unpaid carers to receive double additional payment. Was this helpful?