“The Biden-Harris Administration is deeply committed to ensuring everyone is able to get the high-quality care they need – within the comfort of their own home or community,” said HHS Secretary Xavier Becerra. “Today we are expanding access to home and community-based services so even more states and territories are equipped to best serve the millions of seniors and people with disabilities across the country.”

“We’re putting the full weight of this agency behind solutions that can meet people where they are and help get them to where they want to be when it comes to health care,” said CMS Administrator Chiquita Brooks-LaSure. “Money Follows the Person has a proven track record of helping seniors and people with disabilities transition safely from institutional care to their own homes and communities. Letting ‘money follow the person’ is key to those successes, and to the Biden-Harris Administration’s commitment to affordable, accessible, person-centered care.”

Awards of up to $5 million are being announced for Illinois, Kansas, and New Hampshire, as well as for American Samoa and Puerto Rico – the first time MFP grants have been made available to territories. These awards will support the early planning phase for their MFP programs. This includes: 

• Establishing partnerships with community stakeholders, including those representing diverse and underserved populations, Tribal entities and governments, key state and local agencies (such as state and local public housing authorities), and community-based organizations;
• Conducting system assessments to better understand how HCBS support local residents;
• Developing community transition programs;
• Establishing or enhancing Medicaid HCBS quality improvement programs; and
• Recruiting HCBS providers as well as expert providers for transition coordination and technical assistance.

A new report from CMS also describes how MFP has helped facilitate more than 107,000 transitions out of institutional settings since 2008. It also indicates that, thanks in part to programs like MFP, more than 85% of people who used Medicaid long-term services and supports in 2019 received HCBS rather than institutional services. First authorized in 2006, MFP has provided states with more than $4 billion to support people who choose to transition out of institutions and back into their homes and communities.

Supporting HCBS is a critical part of the Biden-Harris Administration’s commitment to helping older adults and individuals with disabilities live safely and independently in their homes and communities. Medicaid is the primary funder of HCBS nationally, and plays a critical role in supporting states’ efforts to strengthen these services for their beneficiaries. Through the American Rescue Plan, President Biden temporarily increased Medicaid funding for HCBS, and every state elected to participate in this program has submitted a detailed plan for how they will use these funds. The administration estimates that this change will ultimately result in $25 billion in increased funding, allowing states to develop innovative ways to address existing HCBS workforce and structural issues, expand the capacity of critical services, and begin to meet the needs of people with disabilities, family caregivers, and providers. In June 2022, HHS notified states that they now have an additional year – through March 31, 2025 – to use this critical funding made available by the American Rescue Plan.

For more information on MFP, visit Medicaid.gov.

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Each year, more than 250,000 women in the United States learn that they have breast cancer, and more than 20,000 find out they have ovarian cancer.

While most of these cancers happen randomly, about 5 to 10 percent are hereditary, meaning they are caused by genetic changes (called mutations) which are passed down in families.

Unfortunately, women with these inherited cancers have few treatment options.

That’s why the Centers for Medicare & Medicaid Services (CMS) recently extended Medicare coverage to laboratory diagnostic tests using next generation sequencing (NGS) for patients with inherited breast or ovarian cancer.

NGS testing gives a more complete profile of cancer cells than is possible with current tests, and may help identify proven, targeted treatments.

NGS tests provide the most comprehensive genetic analysis of a patient’s cancer because they can simultaneously detect multiple types of genetic alterations. CMS first began covering laboratory diagnostic tests using NGS in March 2018 for Medicare patients with advanced cancer that met specific criteria. With CMS’ recent coverage decision, more Medicare patients will have access to NGS to assist in managing other types of inherited cancers to reduce mortality and improve health outcomes.

Innovative technologies are transforming American medicine, and CMS is closely monitoring the rapid development of new tests and tools for diagnosing cancer. We want to do everything we can to support women’s health and help patients get the care they need.

In addition to providing access to this testing for women, Medicare also covers testing for prostate cancer.

All men are at risk for prostate cancer. Out of every 100 American men, about 13 will get prostate cancer during their lifetimes, and two or three men will die from it.

The most common risk factor is age. The older a man is, the greater his chance of getting prostate cancer.

Some men are at increased risk for prostate cancer. You’re at increased risk for getting or dying from prostate cancer if you’re African-American or have a family history of prostate cancer.

Medicare Part B covers digital rectal exams and prostate specific antigen (PSA) blood tests once every 12 months for men over 50 (beginning the day after your 50th birthday).

Beneficiaries pay 20 % of the Medicare-approved amount for a yearly digital rectal exam and for physician services related to the exam. The Part B deductible ($198 in 2020) applies. In a hospital outpatient setting, there’s also a copayment.

Beneficiaries pay nothing for a yearly PSA blood test. If you get the test from a doctor who doesn’t accept Medicare payment, you may have to pay an additional fee for the doctor’s services, but not for the test itself.

In 2018, the U.S. Preventive Services Task Force made the following recommendations about prostate cancer screening:

• Men who are 55 to 69 years old should make individual decisions about being screened for prostate cancer with a PSA test.

• Before making a decision, men should talk to their doctor about the benefits and harms of screening for prostate cancer, including the benefits and harms of other tests and treatment.

• Men who are 70 years old or older should not be screened for prostate cancer routinely.

September is National Prostate Cancer Awareness Month, and October is National Breast Cancer Awareness Month. Please take a moment to familiarize yourself with the many preventive screening services that Medicare offers for cancer and other diseases, at: https://www.medicare.gov/coverage/preventive-screening-services.

-Seema Verma

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