Skip to main content
Explain the role of waivers with CMS. How do these contribute to the development of State Medicaid Plans (SPA's)?
Answer question in 250 words or more and use 2-3 peer references. APA Style

ANSWER

When we talk about waivers usually it gives you an right not to obey certain rules that actually you had to follow in course of action. Here in case of medicaid programmes we may need to alter certain rules like area to be covered under program, type of medical service covered, eligibility of people to be served under program etc and here waivers and SAP's allows you to do so.
Each states formulates the Medicaid programmes and main aim of such programme is to provide health coverage with low or free of cost to low income families, age old persons, pregnant women, handicaps (people with disabilities ) etc. Which involves investment of large amount of money, And it is contributed by state government as well as federal government, you can expect up to 50% contribution by federal government.
Before starting any medicaid programme you have to take approval from the government and besed on fulfillment of certain requirements approval will be given. Later on if state wants to make any changes in existing medicaid programmes  it must take permission from CMS (centre for medicare and medicaid services ) and it has 2 ways to get permission
  1. Waivers
  2. State plan amendments (SPA's)
Working of waiver and SPA's with CMS
* waivers
In order to waive certain requirements you have to take make formal request to CMS under following categories of waivers,
  • 1115 demonstrations
  • 1915 (b) managed care waivers
  • 1915 (c) home and community based waivers
  • Combined of 1915 (b) and (c)
Waivers are approval for specific time period ( 3 to 5 years) based on type of waivers and it can be renewed.
* SPA's
When state wants to make any kind of permanent changes to medical plans it goes for amendments and you don't have any kind of categories to cover that means it can be related to type of service, eligibility to get aid, area to be covered etc.
Once it is amended it's like permanent change and no need to be cost effective but in case of waivers you should be cost effective to get approval. CMS can make request for extra information or clarification, After that you will get approval with in time period of 90 days.
So, waivers and SPA'S make medical and medicaid programmes more flexible based on requirement of state as well as society.
( Reference - www.familiesusa.org/resources/publications
  https://www.cms.gov)

Comments

  1. https://www.chegg.com/homework-help/construct-example-show-three-guard-bits-needed-produce-corre-chapter-9-problem-25p-solution-9780073380650-exc

    ReplyDelete

Post a Comment

Popular posts from this blog

Question: prove by induction 2^2 + 4^2 + 6^2 + ... + (2n)^2 = (2n)(2n+1)(2n+2)/6 ANSWER we will use induction on n base case : n=1 we have, 2^2 = 2*3*4/6 = 4 which is true inductive hypothesis let it be true for n = k i.e.,  2^2 + 4^2 + ... + (2k)^2 =   [(2k)(2k+1)(2k+2)]/6 inductive case let n = k+1 then we have 2^2 + 4^2 + .... + (2k)^2 + (2(k+1))^2 =   [(2k)(2k+1)(2k+2)]/6 + (2k+2)^2 =(2k+2)*[(2k)(2k+1)/6 + (2k+2)] =(2k+2)*[ (4k^2+2k)/6 + (12k + 12)/6 ] =(2k+2)*[ (4k^2+14k+12)/6 ] = =(2k+2)*[(2k)(2k+1)/6 + (2k+2)] =(2k+2)*[ (4k^2+2k)/6 + (12k + 12)/6 ] =(2k+2)*[ (4k^2+14k+12)/6 ] = (2k+2)*[ (4k^2 + 8k + 6k + 12)/6 ] = (2k+2)*[ (4k(k + 2) +6(k+2))/6 ] = (2k+2)*[ (4k+6)(k+2)/6 ] =  (2k+2)*[ 2 (2k+3)(k+2)/6  ] =   (2k+2)*[  (2k+3)*2*(k+2)/6  ] =   (2k+2)*[  (2k+3)(2k+4)/6  ] = [(2*(k+1))(2*(k+1)+1)(2*(k+1)+2)]/6 replacing k+1 by m, we get replacing k+1 by m, we get [(2*m)(2*m+1)(2*m+2)]/6 this completes our proof b...

IT management

FIGURE P1.1 The File Structure for Problems 1-4 1.       How many records does the file contain? How many fields are there per record? 2.       What problem would you encounter if you wanted to produce a listing by city? How would you solve this problem by altering the file structure? 3.       If you wanted to produce a listing of the file contents by last name, area code, city, state, or zip code, how would you alter the file structure? 4.       What data redundancies do you detect? How could those redundancies lead to anomalies? Figure P2.4 The DealCo relational diagram 4. Identify each relationship type and write all of the business rules. 5.       Create the basic Crow’s Foot ERD for DealCo. FIGURE P3.17 The Ch03_TransCo Database Tables     17. For each table, identify the primary key and the for...
Question: Q1 a. Sketch the static characteristics of a diode. (6 marks) b. An AC voltage source V drives a transformer with centre tap second indin gs connected to two rectifiers is shown in the following diagram. The load has constant current Io. Assume that when the diode conducts the forward voltage drop is Ve d V Vmsnot. The turns ratio is N: 1:1. Sketch the current waveform through one of the diodes. (6 marks) c. Write down an equation for efficiency of a power converter in terms of output power and converter losses (2 marks) d. Given the following parameters, calculate the efficiency of the power converter. Va = 310 V ω-2π50 forward voltage drop of the diodes VF = 0.7 V Transformer turns ratio = 10: 1 : 1 load current = 10 A Assume that the transformer has no loss and converter losses come from the diodes only. Also assume the diode voltage drop does not change with current. State your assumption if there is any 6 marks) ANSWER