Leavitt proposes states shift care from nursing homes to home care

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The Bush administration might work toward loosening a requirement that states provide long-term care in nursing homes, suggests Health and Human Services Secretary Michael Leavitt.

Changing such a requirement for states would require legislative action by Congress. Currently, states must secure a waiver from the Centers for Medicare & Medicaid Services to shift nursing home patients to home- or community-based care. Keeping the elderly out of nursing homes would save on Medicaid costs, Leavitt said late last week.

He previously announced other plans for stretching Medicaid dollars and eliminating waste, fraud and abuse. He also said recently he wants to close loopholes that allow nursing home residents to transfer or hide assets in order to be Medicaid eligible.

The new secretary also said he wants to close the loopholes that states use to maximize federal payments to state Medicaid programs. These loopholes could allow states to shift nearly $40 billion in Medicaid costs to the federal government over the next decade, he said.