VA-Dillard, Ginger

Co-Payments Should Not Be Allowed in Medicaid for Community-Based Long-Term Services and Supports The Medicaid program should encourage people to use community-based long-term services and supports, to promote health and independence. There is no good reason to charge co-pays and other payments for these needed services. Out-of-pocket costs discourage people from receiving ongoing needed services and lead to costly institutional care. The current proposed regulations give states the option to charge co-payments and premiums for community-based long-term services and supports. We recommend that states be required to exempt community-based long-term services and supports from co-payments and premiums. Nursing home residents already have such an exemption. States should not be allowed to discriminate unjustifiably against beneficiaries who prefer to live at home and in the community. Under our proposal, the following persons would be exempted: (v) Any individual who, as a condition of receiving services in an institution is required to spend all but a minimal amount of the individual's income required for personal needs. (vi) At state option, this exemption may be applied to Any individuals receiving long-term services or supports in a home and community-based setting if they individual isare eligible under Section 1902(a)(10)(A)(i) or required to contribute to the cost of their care. Proposed 42 C.F.R. § 447.56(a)(1)(v).