Long-term care ombudsman programs can tap Medicaid for the first time, CMS announces

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Long-term care ombudsman programs can tap Medicaid for the first time, CMS announces
Long-term care ombudsman programs can tap Medicaid for the first time, CMS announces

For the first time, the federal government will offer Medicaid funds to help finance long-term care ombudsman programs, the Centers for Medicare & Medicaid Services recently announced.

The long-term care ombudsman (LTCO) program is primarily funded through Older Americans Act appropriations. CMS has been resistant to offering Medicaid dollars, but the agency worked with the Administration for Community Living to identify ombudsman services that will now qualify for Medicaid matching funds.

The ACL was created in 2012 to support seniors and disabled people living in community settings rather than nursing facilities. Some of the Medicaid matching funds would go toward activities related to this mission, such as for helping Medicaid-eligible residents transition out of skilled nursing facilities. However, ombudsman programs may receive matching funds for a variety of activities that benefit the Medicaid program, including identifying and reporting suspected Medicaid fraud. A CMS bulletin released Tuesday explains qualifying services and exclusions.

CMS announced the Medicaid funding on the same day that the Department of Health and Human Services released a comprehensive federal framework for long-term care ombudsman programs. The long-awaited rule aims to create more uniformity among the sometimes controversial programs, which are administered at the state level.

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