Grants and Demonstrations

The ACA provides funding opportunities to transform how health care is delivered, expand access to care and support healthcare workforce training.

Grant Announcements

Demonstration Grant for Testing Experience and Functional Tools in Community-Based Long Term Services and Supports, §2701. Announced August 24, 2012. Funding is available to test and evaluate new measures of functional capacity and individual experience for community-based long term services and supports (CB-LTSS) populations. Single State Medicaid Agencies are eligible to apply. The objective of this demonstration is to field test both an experience survey for validity and reliability and a "modified" Continuity Assessment Record and Evaluation tool for use with beneficiaries of CB-LTSS. In addition, grantees, with the permission of the beneficiaries, will use web-based Personal Health Records (PHR) for field testing. This will help develop standards for an electronic Long-Term Services and Supports (e-LTSS) record. States will use funds to adopt a PHR model and connect PHR with state IT systems and e-LTSS records. $45M in 10 awards is available.   

Applications are due October 22, 2012.

The announcement can be viewed at: GrantSolutions.gov

Affordable Care Act State Health Insurance Assistance Program (SHIP) and Aging and Disability Resource Center (ADRC) Options Counseling for Medicare-Medicaid Individuals in States with Approved Financial Alignment Models, §3021. Announced August 23, 2012. Funding is available for education and outreach to states that are implementing the State Financial Alignment Initiative. Eligible applicants are states that have signed a Memorandum of Understand (MOU) with CMS to implement this initiative. The State Financial Alignment Initiative is a Federal-state partnership that is testing the alignment of service delivery and financing of Medicare and Medicaid programs to better serve dually eligible beneficiaries. Grantees will work to develop and implement a strategy and action plan to provide beneficiaries with culturally and linguistically appropriate information and one-on-one counseling on this initiative, including when and how this project will be implemented, options for receiving benefits and appeal rights under this new model. $5M in approximately 15 awards is available to states. 

Applications can be submitted September 24, 2012; November 2, 2012; January 18, 2013; April 4, 2013; June 6, 2013 and August 15, 2013.

The announcement can be viewed at: GrantSolutions.Gov

Grant Activity

Massachusetts was awarded a $588,130 Consumer Assistance Program (CAP) grant in partnership with Health Care for All (HCFA) under §1002 of the ACA. Massachusetts was one of 24 states to receive funding from CCIIO to help states establish or support health insurance CAP programs that help consumers who have questions or concerns regarding their health insurance.

Using these funds, Massachusetts and HCFA will: Educate consumers about their rights with respect to group health plan and health insurance coverage; enroll consumers in health care coverage of all types and payers; track and analyze data along numerous data points and over time in order to identify and address systemic barriers to access and enrollment into affordable health coverage options; file complaints and appeals for internal or external grievances processes, and provide independent legal assistance to consumers as they navigate the appeals process with respect to group health plans and health insurance coverage; conduct a targeted, culturally and linguistically appropriate consumer health care outreach and education campaign to non-and-limited English-speaking communities through ethnic media channels and build greater capacity and more accessibility through additional access points for consumers through community-based organizations.

In 2010 HHS distributed nearly $30 million in CAP grants to help states and territories establish or enhance activities to educate consumers about their health coverage options and to ensure consumer access to their rights under state and federal law, including the ACA. In October 2010, Massachusetts was awarded a one-year $742,888 CAP grant to be used in partnership with HCFA to provide consumers statewide with assistance and up-to-date information about health care coverage options and issues (in several languages) as they navigate the health insurance system and to assist consumers with health insurance appeals.

For more information on all CAP awards, visit:  

News

8/24/12 CMS awarded approximately $20 million in Consumer Assistance Program (CAP) grants to 24 states for the establishment or support of independent offices for health insurance CAP programs that help consumers who have questions or concerns regarding their health insurance. Massachusetts received a $588,130 CAP grant in partnership with Health Care for All (HCFA) under §1002 of the ACA.

Using these funds, CAP grantees will: Help consumers enroll in health coverage, including group health plans and other health insurance coverage; help consumers file complaints and appeals against health plans; educate consumers about their rights and empower them to take action; and track consumer complaints to help identify problems and strengthen enforcement.

These grants build on nearly $30 million in Consumer Assistance Program grants awarded to states and territories in 2010 and 2012.

A summary of how each state or territory will use the new resources can be found at: http://www.healthcare.gov/news/factsheets/2010/10/capgrants_states.html .

For more information on the CAP program visit:

http://www.healthcare.gov/law/features/rights/consumer-assistance-program/ 

8/23/12 HHS announced Affordable Insurance Exchange grant awards to 8 states to help them create exchanges under §1311 of the ACA. Establishment Grant funding provides resources to states to set up exchanges and implement the ACA. States receiving Level One Exchange Establishment grants awards, which provide one year of funding to states that have begun the process of building their Exchange, are: California, Hawaii, Iowa, and New York. HHS also announced that Connecticut, Maryland, Nevada, and Vermont were awarded Level Two Establishment grants, which are provided to states that are further along in building their Exchange and offers funding over multiple years.

Previously, 49 states, the District of Columbia and four territories received grants to begin planning their Exchanges. With today's awardees, 34 states and the District of Columbia have received Establishment grants to begin building their Exchanges.

Massachusetts has received three grant awards to build its Affordable Insurance Exchange. Massachusetts received a $1 million planning grant in September 2010. In addition, Massachusetts is the leading partner in a consortium of the six New England states that received a $35.6 million Early Innovator grant in February 2011. In February 2012 Massachusetts received an $11.6 million Level One Exchange Establishment Grant.

On June 29, 2012 HHS announced a funding opportunity providing states with 10 additional opportunities to apply for funding to establish a state-based Exchange, state Partnership Exchange, or prepare state systems for a Federally-facilitated Exchange. States can apply for Exchange grants through the end of 2014, and may use funds during the initial start-up year.

HHS will continue to award exchange establishment grants through 2014.

For a detailed state-by-state breakdown of grant awards including each state's plan for how to use its Exchange funding, visit: http://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html 

More information on Massachusetts' state awards can be found at:

http://www.healthcare.gov/news/factsheets/2011/05/exchanges/ma.html 

For more information on Exchanges, including fact sheets, visit  http://www.healthcare.gov/exchanges 

8/22/12 The CMS Innovation Center announced that 500 primary care practices will participate in the Comprehensive Primary Care (CPC) initiative, a funding initiative authorized through the Innovation Center under §3021 of the ACA. This represents over 2,000 primary care doctors and nurse practitioners in seven markets across the country.

The CPC initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. Under the new initiative, Medicare will work with commercial and state health insurance plans to offer additional support to primary care doctors who better coordinate care for their patients. Arkansas, Colorado and Ohio Medicaid will participate in the initiative, as will the Oklahoma Health Care Authority and the Oregon Health Authority, which oversee their respective states' Medicaid programs.

CMS will pay primary care practices a care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services. Under this initiative, each practice will receive the new care management fee in addition to traditional fee-for-service payments on behalf of Medicare fee-for-service beneficiaries. Enhanced services include: improved care coordination; delivering preventive care; engaging patients and caregivers in managing their own care, and providing individualized care for patients with multiple chronic diseases.

According to CMS, insurers in the seven markets signed agreements with CMS to participate in this initiative. They were selected based on a pool of applicants, which include private health plans, state Medicaid agencies, and employers, that proposed to pay for and support comprehensive primary care coordination in partnership with Medicare. The selected markets are: 1) Arkansas: Statewide, 2) Colorado: Statewide, 3) New Jersey: Statewide, 4) New York: Capital District-Hudson Valley Region, 4) Ohio: Cincinnati-Dayton Region, 5) Oklahoma: Greater Tulsa Region, and 6) Oregon: Statewide. Approximately 75 primary care practices will be selected to participate in the initiative in each designated market. 

The Comprehensive Primary Care initiative is a four-year initiative administered by the Innovation Center designed to test a model of improved access to quality health care at lower costs. The 500 practices were selected through a competitive application process and will start delivering enhanced health care services this fall. To learn more about the Comprehensive Primary Care initiative and view the participating primary practices, payers, and markets please visit: http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative

 EOHHS News

Memorandum of Understanding with CMS

EOHHS and CMS signed a Memorandum of Understanding (MOU) authorizing the Massachusetts Duals Demonstration on August 22, 2012.  The MOU signifies CMS's official approval of the Massachusetts Duals Demonstration.

The MOU and an addendum are available at the Integrating Medicare and Medicaid for Dual Eligible Individuals website at: www.mass.gov/masshealth/duals under Related Information. 

Upcoming Events

Integrating Medicare and Medicaid for Dual Eligible Individuals Open Meeting

August 31, 2012, 10:00 AM - 12:00 PM

1 Ashburton Place, 21st Floor, Conference Rooms 1, 2, & 3,

Boston, MA

The purpose of this meeting will be to give an update on the Demonstration, and to focus on consumer and implementation issues. 

Reasonable accommodations will be made for participants who need assistance. Please send your request for accommodations to Donna Kymalainen at Donna.Kymalainen@state.ma.us

Quarterly Affordable Care Act Implementation Stakeholder Meeting

Wednesday, September 19, 2012, 1:00 PM- 2:00 PM

1 Ashburton Place, 21st Floor

Boston, MA