CMS Approves Oklahoma’s Tiered Medicaid Expansion
On Oct. 20, the Centers for Medicare & Medicaid Services (CMS) approved a request by Nebraska to allow the state to implement a two-tiered Medicaid benefits package for its expansion populations.
Regular readers of the ADEA Advocate may recall that earlier this month it was reported Nebraska would begin enrolling beneficiaries into its Medicaid expansion program, but the state was waiting for CMS to approve or deny a waiver to allow the new program to go into effect.
Nebraska is now permitted to move forward with its two-tiered plan. Under the plan, coverage in the upper tier, or the prime plan, includes benefits that are common for non-expansion Medicaid beneficiaries. Coverage in the lower tier, or the basic plan, does not include the full package of benefits, as it excludes dental, vision and over-the-counter medication. Coverage in the upper tier must be earned by beneficiaries who are not pregnant, medically frail or adults 19 to 20 years of age, through specific wellness activities, and in 2022, by fulfillment of a work requirement.
Work requirements have been struck down by federal courts in multiple states. It remains to be seen, however, if Nebraska’s two-tiered approach, which ensures a basic level of benefits for everyone in an expansion population, will be upheld.
