The Senate has passed H.R. 1839, the Medicaid Services Investment and Accountability Act, which provides a six-month extension for the Medicaid home and community-based services (HCBS) spousal impoverishment protections. The legislation also includes another $20 million for the Money Follows the Person (MFP) Rebalancing Demonstration Grant, that help states rebalance their Medicaid long-term care systems.

The Administration for Community Living (ACL) has offered grant funding to states and community-based programs to build and expand home and community-based services (HCBS) specifically for people with dementia since 2014. The purpose of these funds has been to develop models of home and community-based care for people living with dementia, including Alzheimer’s, and ultimately to identify models that could help realize a dementia-capable HCBS system.


On January 17, 2019, the Senate passed the Medicaid Extenders Act of 2019 (H.R. 259) which provides short-term funding for the Money Follows the Person (MFP) Demonstration Grants that helps states rebalance their Medicaid long-term care systems. The Act also includes a short-term extension of protections for Medicaid recipients of home and community-based services (HCBS) against spousal impoverishment. This is the same bill that the House of Representatives passed on January 8, and it now heads to the White House, where it is expected to be signed into law.

New Rules:  The passage of legislation in 2018, such as the Bipartisan Budget Act of 2018 which contained provisions of the CHRONIC Care Act, will lead to changes in the types of benefits Medicare Advantage (MA) plans may offer in 2020 and beyond and what is expected of both MA and Special Needs Plans (SNPs).  CMS closed 2018 with the publication of a series of proposed and final rules that will govern MA, SNPs, and Medicaid managed care plans for 2020 and beyond. 


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