Today, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director letter providing guidance to inform States of opportunities to provide Medicaid coverage to individuals living with HIV in support of President Obama’s National HIV/AIDS Strategy.
This guidance informs States on how to apply for opportunities in the Medicaid program that allow for flexibility to improve care and care coordination and offer options to treat individuals living with HIV (including individuals living with AIDS, which refers to individuals living with an advanced stage of the HIV disease) in the community. States may choose to apply for one or more options to extend coverage to individuals living with HIV: Community First Choice; Health Home for Enrollees with Chronic Conditions; Section 1915(c) Home and Community Based Services Waiver; Section 1915(i) State Plan option; Money Follows the Person Rebalancing Demonstration; and Section 1115 Demonstrations.
These coverage and service design opportunities may assist States in increasing access to care for individuals living with HIV, provide alternatives that could alleviate the current burden to AIDS Drug Assistance Programs (ADAP), and help States make progress towards expanding coverage and providing access in accordance with the Affordable Care Act requirements.
