In January 2023, the Centers for Medicare & Medicaid Services (CMS) published new guidance to help states enhance and expand efforts to address health-related social needs of Medicaid enrollees through a category of services known as “in lieu of a service” (ILOS). This guidance — along with other recent changes to waivers, regulations, and requirements — adds nationwide momentum to efforts to integrate health and social care and reduce inequities for people covered by Medicaid. The guidance is also timely, as states, plans, and providers prepare for the anticipated ending of the federal COVID-19 public health emergency and with it, the potential loss of Medicaid coverage for millions of individuals and increase in unmet social needs.
This webinar, cohosted by HealthBegins and the Center for Health Care Strategies (CHCS), explored CMS’ new guidance, what it means for Medicaid agencies and managed care organizations, and how to navigate challenges in using this new funding mechanism, including how to maximize its potential to support equity.
- Aditi Mallick, MD, Chief Medical Officer, Center for Medicaid and CHIP Services, CMS
- Sadena Thevarajah, JD, Managing Director, HealthBegins
- Diana Crumley, JD, MPAff, Senior Program Officer, CHCS
- Richard Sheward, MPP, Director of System Implementation Strategies, Children’s HealthWatch, Boston Medical Center
- Jennifer McGuigan Babcock, MPH, Senior Vice President of Medicaid Policy, Association for Community Affiliated Plans
- State Medicaid Directors Letter: Additional Guidance on Use of In Lieu of Services and Settings in Medicaid Managed Care (January 2023)
- Addressing HRSN Through Section 1115 Demonstrations (note, see related resources sidebar)
- California CalAIM 1915b ILOS Waiver Approval Letter (December 2021)