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HHS Allows States Flexibility to Address Medicaid Beneficiaries' Social Needs

Analysis  |  By Jay Asser  
   January 06, 2023

States will have the opportunity to give additional benefits through the use of "in lieu of services and settings."

HHS is offering states greater flexibility to address health-related social needs for people enrolled in Medicaid, the department announced.

As part of the Biden administration's efforts to bolster Medicaid, the initiative gives states an opportunity to provide alternative benefits through the use of "in lieu of services and settings" in Medicaid managed care.

The benefits focus on a range of unmet social needs, such as food insecurity and housing instability, to help beneficiaries maintain their coverage as well as improve their health outcomes.

"We are deeply committed to strengthening Medicaid for the millions of Americans covered by it," HHS secretary Xavier Becerra said. "Today's step ensures people with Medicaid receive the broader care they need to live safe and healthy lives. We call on all states to leverage these innovative options and stand ready to partner with them in providing essential health care services."

CMS administrator Chiquita Brooks-LaSure said: “Today’s announcement is the next step in CMS' effort to use every lever available to protect and expand coverage for all eligible individuals as we work with our state partners to offer whole-person care.”

HHS stated that the initiative also allows states to adopt in lieu of services and settings to provide tailored meals for people with severe, chronic conditions that are worsened by poor diet, living in "food deserts," or not having access to nutritional choices.

The announcement additionally establishes the requirements and guardrails states must meet to ensure the actions are medically appropriate, cost effective, preserve enrollee rights and protections, and fulfill Medicaid objectives.

Read the full letter here.

Jay Asser is the contributing editor for strategy at HealthLeaders. 

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