United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2003-06-20 monographic deposited born digital 70 p. GA 1.13:GAO-03-576 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-03-576 P0b002ee180385446 f:d03576 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-03-576 machine generated eng fdlp REPORT GAOREPORTS-GAO-03-576 GAO-03-576 Federal funds Health care costs Health care programs Health care services Elder care Long-term care Waivers Quality assurance Federal/state relations State-administered programs Medicaid Program Other Written Product A07309

Home and community-based settings have become a growing part of states' Medicaid long-term care programs, serving as an alternative to care in institutional settings, such as nursing homes. To cover such services, however, states often obtain waivers from certain federal statutory requirements. GAO was asked to review (1) trends in states' use of Medicaid home and community-based service (HCBS) waivers, particularly for the elderly, (2) state quality assurance approaches, including available data on the quality of care provided to elderly individuals through waivers, and (3) the adequacy of federal oversight of state waivers. GAO is recommending that the Administrator of CMS take steps to (1) better ensure that state quality assurance efforts are adequate to protect the health and welfare of HCBS waiver beneficiaries, and (2) strengthen federal oversight of the growing HCBS waiver programs. Although CMS raised certain concerns about aspects of the report, such as the respective state and federal roles in quality assurance and the potential need for additional federal oversight resources, CMS generally concurred with the recommendations. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-03-576/html/GAOREPORTS-GAO-03-576.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-03-576/pdf/GAOREPORTS-GAO-03-576.pdf GAO-03-576 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-03-576 Other Written Product GAO-03-576; Long-Term Care: Federal Oversight of Growing Medicaid Home and Community-Based Waivers Should Be Strengthened; Federal funds Health care costs Health care programs Health care services Elder care Long-term care Waivers Quality assurance Federal/state relations State-administered programs Medicaid Program Title 42 Section 1396n 42 U.S.C. 1396n Title 42 Part 441.302 42 CFR Part 441.302 Title 42 Part 441.304 42 CFR Part 441.304