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May 17, 2018

CMS will not approve lifetime Medicaid coverage limits, Verma says

Daily Briefing

    CMS Administrator Seema Verma on Tuesday said the Trump administration will not approve state waiver requests seeking to implement lifetime limits on Medicare coverage.

    During an event sponsored by the Washington Post, Verma said while the administration has approved Medicaid waivers that impose "temporary lapses in coverage," meaning "an individual may not comply with [for example] a requirement around cost-sharing and potentially lose coverage," the administration "want[s] to make sure there's a pathway back into the program." She continued, "In the Medicaid program, you're dealing with a fragile population and there are changes in their lives—they may be able to go into a community engagement program, get a job, [and become] independent, but circumstances change, and we always want to make sure the program serves as a safety net and there's a place for people to go if they need it."

    Verma cited CMS' recent decision to reject a waiver request from Kansas to implement a three-year limit on Medicaid coverage for certain beneficiaries, saying, "We indicated we would not approve lifetime limits, and have made that pretty clear to states." Four other states—Arizona, Maine, Utah, and Wisconsin—have submitted waiver request to CMS that seek to implement Medicaid coverage limits, CQ Health reports.

    According to The Hill, Verma did not indicate whether CMS would approve other Medicaid waiver requests that states have submitted, such as whether the agency will allow states that have not expanded Medicaid under the Affordable Care Act to implement work requirements for certain beneficiaries. In addition, Verma did not say whether CMS would approve Wisconsin's request to screen Medicaid beneficiaries for drug use (Frieden, MedPage Today, 5/15; Weixel, The Hill, 5/15; Williams, CQ Health, 5/15 [subscription required]).

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