Status Update on Federal Spousal Impoverishment Protections for HCBS

The U.S. House of Representatives recently passed the IMPROVE Act (H.R. 7217), which temporarily extends spousal impoverishment protections of older adults and people with disabilities receiving Medicaid home and community-based services (HCBS). Enacted as part of the Affordable Care Act (ACA), these protections allow married couples to protect certain assets while seeking Medicaid coverage for HCBS.

The bill also extends the Medicaid Money Follows the Person (MFP) demonstration program as well. MFP provides transitional care and services to patients as they move from institutional to non-institutional settings. Both programs are set to expire Dec. 31, 2018. The bill is currently before the U.S. Senate for consideration, though it is unclear whether the Senate will act before the end of the year.

The IMPROVE Act also establishes a new Medicaid program designed to move pediatric patients with medically complex conditions from institutional settings into community settings. You can read the bill here.

The New York State Department of Health (DOH) has assured LeadingAge NY that spousal impoverishment protections for HCBS recipients will remain in place under its existing 1115 waiver despite federal expiration. This protects HCBS services offered in 1915 waivers as well. The provisions were negotiated with the Centers for Medicare and Medicaid Services (CMS) prior to enactment of the ACA.

Contact: Meg Carr Everett, meverett@leadingageny.org, 518-867-8871