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CMS Issues Guidance to States on BIPP

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CMS Issues Guidance to States on BIPP

September 16, 2011

The Centers for Medicare and Medicaid Services (CMS) sent a letter and application to State Medicaid Directors earlier this week, providing guidance to implement the new Medicaid Balancing Incentives Payments Programs (BIPP) option.

The option will become effective October 1, 2011 and will provide an enhanced FMAP to states to stimulate increased access to home and community based services. Section 10202 of the Affordable Care Act provides $3 billion in new funding to assist states “rebalance” their LTSS systems.

States must apply for these non-competitive grant awards and agree to undertake structural reforms and advance non-institutional long-term services and supports. States must submit a work plan in which they agree to develop a “no wrong door”/single entry point system; conflict-free case manage services; and a core standardized assessment instrument within six months from the date of application submission and have these structural changes in effect no later than September 15, 2015.

States can qualify for a 5% FMAP increase if less than 25% of the total 2009 LTSS expenditures were for non-institutional LTSS and states that have less than 50% of the total 2009 LTSS expenditures were for non-institutional LTSS can qualify for receiving 2% increase in the FMAP.

More details regarding a state’s eligibility (i.e., classification of LTSS), benchmarks, and structural changes are in the application.

ANCOR encourages providers to urge their states to apply as we pushed hard for an enhanced FMAP bill in ACA—although a more limited funding provision and other conditions were included in the final provision.