Nzira dzeNyika dzinoshandisa Medicaid Waivers kuti dzigadzirire zvirongwa zveMedicaid
Medicaid inobhadharwa pamwe nehurumende yehurumende uye hurumende yehurumende, kupa rubatsiro kune vamwe vanhu nemhuri dzine mari shoma isina hutano yehutano uye avo vanochengetwa nehutano vangangodaro basa guru rezvemari. Medicaid inotungamirirwa nemunhu mumwe nemumwe, uye mitemo yakakodzera inopesana nehurumende kuenda kune imwe nyika.
Aiiver Medicaid inobvumira nyika kuti iedze uye inovandudza nzira iyo inopa iyo Medicaid-inobhadhara mari yezvirongwa zvakasiyana kubva purogiramu yakazara yehurumende.
Aya mapurogiramu angave ane zvido zvakasiyana-siyana zvekufanirwa, kana zvirongwa zvingashanda semasangano ekutarisira anotarisirwa. Semuenzaniso, zvirongwa zveMedicaid zvingave zvakagadzirirwa vanhu vanodikanwa mune zvido, zvakadai sevakwegura kana vakadzi vakabatwa.
MuUnited States, Medicaid ndiyo yepamusoro-soro yemari inobhadharwa nehutano hwehutano hwezvokurapa uye zvehutano zvinodiwa zvevanhu vane mari shoma. Kunyange zvazvo nyika yose ikozvino inogamuchira imwe Medicaid mari uye ine maProjectid yavo pachake, zvirongwa izvozvo zvinosiyana. Mukuwedzera pakukwanisa kushanda kweMedicaid waiver, nyika dzinogonawo "kusarudza-kunze" yekugamuchira mishonga yeMedicaid itsva uye zvinoda.
Waivers inogonawo kushandiswa kuHana Health Health Program (CHIP), iyo inopa mari yehurumende kufanana nehurumende mari yezvirongwa zvekuvhara vana vasina mhuri uye vasina mhuri vasina mari asi haigoni kusangana neMedicaid kukodzera.
Medicaid Waivers
Medicaid waiver inogona kuenda nemazita akasiyana-siyana.
Aya mazita anosanganisira 1115 waivers (yakagadzirirwa neChikamu 1115 cheSocial Security Act), 1915 waivers (yakagamuchirwa neChikamu 1915 cheSocial Security Act), kusunungura mabasa, kusunungura mapurogiramu, Home and Community Based Services (HCBS) kusunungura, pamwe chete anonyanya kutaurwa kune dzimwe nyika.
Kune marudzi akawanda eMedicaid waivers, kunyange zvazvo akawira pasi pesimba reZvikamu 1115 ne1915 zveSocial Security Act:
- Chikamu 1115 vashandi vanobvumira kutsvakurudza nekuratidzira zvirongwa zvakagadzirirwa kuedza kwenguva yakareba kukodzera kana kukwanisa kushandiswa, uyewo nzira dzokubhadhara nekupa Medicaid. Chikamu 1115 zvipfeko zvinowanzobvumira "pilot" kana "kuratidza" zvirongwa zvinotarisirwa kuwedzera kana kukurudzira kugoverwa nekubudirira. Nekuwedzerwa kweMedicaid pasi peCount Affordable Care Act, 1115 waivers yatova yakakurumbira sehurumende inotarisa nzira dzakasiyana-siyana dzekushandisa Medicaid kuwedzera uye kushandisa zvimwe zvekubhadhara mari yehurumende yakaenderera kune dzimwe nyika kuti iwedzere ruzivo rwekugoverwa. Kuti zvibvumirwe, Chikamu 1115 chaiveri inofanirwa kuve bhajeti risinei nehurumende yehurumende (kureva kuti, hurumende yehurumende haigoni kupedza zvakawanda pamwe chete nevanorega panzvimbo panzvimbo yavanopedza pasina iyo).
- Chikamu 1915 (b) kusunungura kunobvumira nyika kuti dzigadzire zvirongwa zvekuchengetedzwa kweMedicaid. State Medicaid masangano anokwanisa kubvumirana nemasangano ekuchengetedza anotarisira (MCOs) kuti abatsire kutarisira unhu, kushandiswa, uye mari, asiwo kushanda pakuvandudza hurongwa hwekuita uye zvirwere zvevarwere. MCOs inopa rubatsiro rwehutano kuvanhu vanoita Medicaid uye vanowana kubhadhara kwezvibasa kubva muhurumende Medicaid fund.
- Chikamu 1915 (c) Mishandirapamwe yeHomes and Community Based Based Services (HCBS) inobvumira vanobatsirwa kuwana rubatsiro rwehutano rwemazuva mazhinji kumusha kana munzvimbo dzomunharaunda kunze kwekugadzirisa zvigaro, semisha inochengeterwa vakwegura . Native American Tribes inogona kubvumirana nehurumende kuti inotonga 1915 (c) kusunungura kuburikidza neIndia Health Services. Munyika yeHCBS, nyika inogonawo kurondedzera 1915 (i) uye 1915 (j) kusunungura, uye 1915 (k) kusunungura, izvo zvose zvinopa humwe humwe hunoenderana nekupa HCBS kune vagari vakakodzera.
- Kusanganiswa kana kuwirirana Chikamu 1915 (b) uye 1915 (c) kuregererwa kunobvumira hurumende kuti ipe hutano hwakaratidzwa muChikamu 1915 (c) nekugadziriswa nemasangano ekuchengetedza anotaridzirwa muChikamu 1915 (b). Masangano ekuchengetedza anotarisirwa anobvumirana nemishandirapamwe anotumira kumusha uye kushandiswa kwehutano hwehutano.
Mitemo uye Waiver Kugadziriswa Nzira
Rumwe rudzi rweMedicaid waiver rine mitemo yakasiyana-siyana inoshanda kune iyo. Peji ino ine chidimbu chakanaka chekusiya zvakasiyana-siyana, kuti vanoshandiswa sei, uye zvinodiwa zvinoshanda kune umwe neumwe.
Nyora yezvose zvinogamuchirwa uye zvakamirira Medicaid waiver inowanika paIndanetiid website. Hurumende inoshandiswa mazano inongororwa uye inobvumidzwa (kana yakarambwa) pane imwe nyaya-ne-case. Chikamu che1115 chaivers chinogamuchirwa kwemakore mashanu pakutanga, nemakore matatu ekuvandudzwa. Chikamu 1915 waiver yakashandiswa kugamuchirwa kwemakore maviri, asi mune mamwe mamiriro ezvinhu, inogonawo kubvumidzwa kwemakore mashanu.
Chii Chinonzi Institutional Care and Home uye Services Based Based Based?
Kune vanhu vanoda kutarisirwa kwenguva refu, vakadai sevakwegura, Medicaid inobhadhara kuchengetwa kweizvi mune zvivako, zvakadai semisha yekuyamwisa. Izvi hazviiti nguva dzose zvichibvira kana kubatsira kumubatsiri, zvisinei. Medicaid yeChikamu 1915 (c) Misha yekuMusha uye yeChechi-Based Services inopa mazano kune avo vasingagari mumisha yevanotarisira. Vakabatsiri vangave vanogara mumisha yavo, kana kuti vanogona kugara nemhuri kana vamwe vanochengeta, kana muhupenyu hwekubatsira kana hwekugara kwepamusoro uye nzvimbo dzakasiyana nedzimwe dzimba dzavo kana dzimba dzevanamukoti.
Medicaid "Sarudza-Kubuda"
Mukuwedzera kune kuregererwa kwekuita zvirongwa zvakasiyana-siyana zveMedicaid, nyika dzinogonawo kusarudza "kusarudza-kunze" kuneimwe Medicaid mari asi huri kuchengetedza mari yakasimbiswa kare.
Iko Inogadziriswa Care Act inopa mari yekuwedzera kweMedicaid kumhuri dzisina mari yakawanda, uye vateereri vemitemo vaida kuita kugamuchirwa kwekubhadhara mari iyi, nehurumende dzisingakwanisi kuchengetedza mari yavo iripo Medicaid mari kana vasina kugamuchira Medicaid kuwedzera mari. Asi Dare Repamusorosoro rinotonga muna 2012 iro rinotaura kuti haringatenderwi kubvuma mari itsva iyi (uyezve, inofanira kugovera chikamu chehurumende chemari yekuwedzera kweMedicaid, iyo ichazopedzisira iri 10 muzana yehuwandu), uye iyo icharamba Medicaid Kuwedzera kwekubhadhara mari hakugone kuunza hurumende kurasikirwa neMedicaid iripo.
Somugumisiro, pane 19 nyika dzisina kuwedzera Medicaid, asi iyo inoramba ichitsvaga pre-ACA iyo federal Medicaid mari.
> Sources:
> Centers for Medicare neMedicaid Services. National Overview ye1915 (c) HCBS Waivers.
> Medicaid.gov. Panenge Chikamu 1115 Zviratidzo.
> Medicaid.gov. Medicaid uye chikwata chekugadzirisa CHIP. June 2016.
> Medicaid.gov. State Waivers List.