Together for Choice was invited to meet with Seema Verma, CMS Administrator, on November 1, to discuss the future of Medicaid. Approximately twenty other organizations participated in this invitation only meeting. The focus of the discussion was CMS’s Settings Rule which defines what constitutes a “community” setting and is therefore eligible for Medicaid waiver funding. I was the only person at the meeting who advocated for choice. I argued that the Settings Rule should be changed to honor the choices of individuals and their families regarding where to live and spend their days and to expand residential and day programming options. All of the other participants said that they did not want any changes to the Settings Rule or the CMS guidance under the Rule.

Administrator Verma stated that she wanted Medicaid to be beneficiary focused and to put people first. She also said that she wanted to provide the states with more flexibility on administering Medicaid programs. In fact, she said that she wanted to give states an “unprecedented level of flexibility. “ She also acknowledged that individuals with disabilities receiving Medicaid should be viewed differently from non-disabled individuals receiving Medicaid. She wants the states to be creative and innovative in developing Medicaid programs and she repeatedly said that she wants less process and more focus on outcomes. In that connection, she said that CMS will be developing a Medicaid scorecard for states. She concluded by saying that we should expect some announcements in the coming weeks on new policies.

Brian Neale, the head of Medicaid services at CMS also spoke. He indicated a preference for revising the CMS guidance to address the unintended consequences of the Rule rather than amend the Rule. When I reiterated the importance of amending the Rule, Administrator Verma asked me to provide CMS with the specific changes I thought were needed. I told her that we had already provided Director Neale with our changes last June. After the meeting, I sent Director Neale a letter thanking him and Administrator Verma for including Together for Choice in this important meeting, urged him to amend the Settings Rule along the lines we suggest, and told him that we looked forward to working with him to preserve choice and expand options for individuals with developmental disabilities.

We will continue to advocate for choice by following up with Administrator Verma and Director Neale. Please join our voices to preserve choice and expand quality options by joining Together for Choice. Click HERE to join.

Thank you

Scott Mendel
Chairman, Together for Choice
www.togetherforchoice.org