Medicaid Transformation Grants to States for the adoption of innovative methods to improve the effectiveness and efficiency in providing medical assistance under Medicaid

The summary for the Medicaid Transformation Grants to States for the adoption of innovative methods to improve the effectiveness and efficiency in providing medical assistance under Medicaid grant is detailed below. This summary states who is eligible for the grant, how much grant money will be awarded, current and past deadlines, Catalog of Federal Domestic Assistance (CFDA) numbers, and a sampling of similar government grants. Verify the accuracy of the data FederalGrants.com provides by visiting the webpage noted in the Link to Full Announcement section or by contacting the appropriate person listed as the Grant Announcement Contact. If any section is incomplete, please visit the website for the Centers for Medicare and Medicaid Services, which is the U.S. government agency offering this grant.

Medicaid Transformation Grants to States for the adoption of innovative methods to improve the effectiveness and efficiency in providing medical assistance under Medicaid: On February 8, 2006, President Bush signed into law the Deficit Reduction Act of 2005 (DRA) (Pub. L. No. 109-171). Section 6081 of the DRA adds a new subsection (z) to section 1903 of the Social Security Act (the Act) which provides grant funds for the adoption of innovative methods to improve the effectiveness and efficiency in providing medical assistance under Medicaid. The Centers for Medicare & Medicaid Services (CMS) will make grants available from the appropriations authorized under section 6081 of the DRA for the costs of the creation and initial operation of technological innovations that are more aligned with today's Medicaid population and the health care environment. New subsection (z) under section 1903 of the Act specifies the criteria for the grants and lists examples of the permissible use of Medicaid Transformation Grant funds. Examples of the permissible use of funds include but are not limited to: %900 Methods for reducing patient error rates through the implementation and use of electronic health records, electronic clinical decision support tools, or e-prescribing programs; Methods for improving rates of collection from estates of amounts owed under Medicaid; Methods for reducing waste, fraud, and abuse under Medicaid, such as reducing improper payment rates as measured by annual program error rate measurement (PERM) projects; Implementation of a medication risk management program as part of a drug use review program under section 1927(g); For purposes of this grant program, a "medication risk management program" means a program for targeted beneficiaries that ensures that covered outpatient drugs are appropriately used to optimize therapeutic outcomes through improved medication use and to reduce the risk of adverse events. Such a program may include the following elements: %901 The use of established principles and standards for drug utilization review and best practices to analyze prescription drug claims of targeted beneficiaries and identify outlier physicians. %901 On an ongoing basis provide outlier physicians: a comprehensive pharmacy history for each targeted beneficiary under their care; information regarding the frequency and cost of relapses and hospitalizations of targeted beneficiaries under the physician's care; and applicable best practice guidelines and empirical references. %901 Monitor outlier physician's prescribing, such as failure to refill, dosage strengths, and provide incentives and information to encourage the adoption of best clinical practices. The term "targeted beneficiaries" in the above description means Medicaid eligible beneficiaries who are identified as having high prescription drug costs and medical costs, such as individuals with behavioral disorders or multiple chronic diseases who are taking multiple medications. Methods in reducing, in clinically appropriate ways, Medicaid expenditures for covered outpatient drugs, particularly in the categories of greatest drug utilization, by increasing the utilization of generic drugs through the use of education programs and other incentives to promote greater use of generic drugs; and Methods for improving access to primary and specialty physician care for the uninsured using integrated university-based hospital and clinic systems. Section 1903(z) encourages states to "adopt innovative methods to improve the effectiveness and efficiency in providing [Medicaid]," a goal which is reflected in the President's Initiative. The Secretary encourages States to apply for grant funds to establish: %900 Methods to increase health care transparency which provide consumers with the information and the incentives to choose health care providers based on value. Examples from current State pilots from Medicare's "Better Quality Information to Improve Care for Medicare Beneficiaries" that could be replicated in the Medicaid program include: o Initiatives to collect and report performance data, promote comparable quality measures, and create efficient data collection; o Collaborations aimed at improving the quality of health care and creating a common, secure, electronic infrastructure to expand information sharing; o Creation of a broad-based health care coalition to promote valid, comparable measures to drive quality improvement; o Initiatives to collaborate to improve community health, build an IT infrastructure, ensure access to data, report value data, and promote beneficiary involvement. Developing verifiable measures for public reporting.