Performance Improvement 2008. To What Extent do Medicaid State Plans and Home and Community-Based Services Waivers Cover Assistive Technology and Home Modification Services?


This study examined the nature and scope of home modification and assistive technology services which States make available to Medicaid-eligible adults. The study provides Federal and State policymakers with basic information for planning and policy development. It provides stakeholders and consumers with valuable information about how these two services are covered by Medicaid State plans or through home and community-based services (HCBS) waivers.

Almost every HCBS waiver lists assistive technology and home modification as a covered service. Medicaid State plans limited what they included under these categories. Considerable variation exists in how States define and refer to the two services. Most waivers, and some State plans, offer service coordination or case management to recipients in order to facilitate access to these key services, and both types of Medicaid services used health professionals (such as therapists) to assess recipient needs. The majority of State plans require physician orders for both services; while only half of the waiver programs listed that as a requirement. Almost all Medicaid State plans use "medical necessity" criteria when determining coverage for assistive technology and home modification services, and half of the HCBS waivers studied used these criteria. Almost all Medicaid State plans and waivers studied required prior authorization of some sort for these services. State HCBS waiver programs used multiple mechanisms to limit or restrict waiver expenditures, whereas Medicaid State plans had few limits (but less extensive coverage for these services).

Report Title: Compendium of Home Modification and Assistive Technology Policy and Practice Across the States: Final Report,
Agency Sponsor: ASPE-ODALTCP, Office of Disability, Aging, and Long-Term Care Policy
Federal Contact: Gavin Kennedy, 202-690-6443
Performer: Abt Associates Inc.

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"PerformanceImprovement2008.pdf" (pdf, 1.29Mb)

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