The Money Follows the Person (MFP) demonstration has provided participating states with flexibility and enhanced funding to support transitioning over 100,000 Medicaid beneficiaries from institutional settings back to the community. MFP participants must be transitioned into specific settings, using a much narrower definition than permitted by the home- and community-based services (HCBS) settings rule. The Consolidated Appropriations Act, 2021 (CAA, P.L. 116-260) directed MACPAC to identify settings that are available to MFP participants and the settings that qualify for HCBS payment under the settings rule. Furthermore, if appropriate, Congress has requested the Commission recommend policies that would align MFP residence criteria with the HCBS settings rule.
In this session, staff presented an overview of a draft chapter for inclusion in the March report to Congress. After lengthy discussion over the past few months of the advantages and disadvantages of the existing MFP qualified residence criteria and potential implications of changes, the Commission concluded that there is not sufficient evidence to support aligning MFP residence criteria with the HCBS settings rule. Thus, the draft chapter outlines the advantages and disadvantages of the current criteria as informed by stakeholder perspectives.