HHS FY 2018 Budget in Brief - CMS - State Grants and Demonstrations

Topics on this page: State Grants and Demonstrations Budget Overview

Centers for Medicare & Medicaid Services (CMS): State Grants and Demonstrations

The Centers for Medicare & Medicaid Services ensures availability of effective, up-to-date health care coverage and promotes quality care for beneficiaries.

State Grants and Demonstrations Budget Overview

(Dollars in millions)

Table Footnotes

1/  The Budget Authority table does not include Funding for the Territories due to a rescission in this program.
2/  Budget authority for the Medicaid Integrity Program is adjusted annually by Consumer Price Index for All Urban Consumers and outlays include some spending from prior year budget authority.  This program is also described in the Program Integrity chapter.
3/  The following programs/laws were excluded from the Current Law Outlays table (either because outlays were less than $1 million or were rescinded): Ticket to Work and Work Incentives Improvement Act, the National Clearinghouse for Long-Term Care Information, and the Psychiatric Residential Treatment Facilities Demonstration.
4/  Outlays are from prior year budget authority.
5/  See CHIP chapter for additional information about this program.
6/  On December 28, 2015, the Centers for Medicare & Medicaid Services announced the sunsetting of this program at the end of Fiscal Year 2016.

The State Grants and Demonstrations account funds a diverse set of program activities, including activities that were authorized in the Patient Protection and Affordable Care Act, the Children’s Health Insurance Program Reauthorization Act (CHIPRA), the Deficit Reduction Act of 2005, and the Ticket to Work and Work Incentives Improvement Act of 1999.  Such activities include strengthening Medicaid program integrity, supporting enrollment of children into Medicaid and the Children’s Health Insurance Program (CHIP) through funding for outreach activities, and promoting prevention and wellness by providing grants to States to prevent chronic diseases.

Enrollment and Retention Outreach
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) provided new funding and extended the Outreach and Enrollment Program for two years through Fiscal Year (FY) 2017.  Originally enacted under CHIPRA, the Outreach and Enrollment Program provides grants and a national campaign to improve outreach and enrollment to children who are eligible for but unenrolled in Medicaid and CHIP.  Of the total $40 million appropriation under MACRA, $32 million is dedicated to outreach and enrollment grants, $4 million is dedicated to outreach and enrollment grants for children who are American Indian/Alaska Native, and $4 million is dedicated to the National Enrollment Campaign.

Medicaid Integrity Program
The Medicaid Integrity Program was established by the Deficit Reduction Act of 2005, which appropriated $75 million in FY 2009 and for each year thereafter.  Congress later increased appropriations for FY 2011 and future years by inflation.

States have the primary responsibility for combating fraud, waste, and abuse in the Medicaid program, but the Medicaid Integrity Program plays an important role supporting State efforts, including through contracting with eligible entities to carry out activities such as Centers for Medicare & Medicaid Services reviews, audits, identification of overpayments, education activities, and technical support to States.  The Medicaid Integrity Program works in coordination with Medicaid program integrity activities funded through the Health Care Fraud and Abuse Control program. 

Money Follows the Person Demonstration
This demonstration, extended by the Patient Protection and Affordable Care Act through FY 2016, helps States support individuals to achieve independence.  While all the money has been obligated, States have continued to operate this demonstration since 2007.  States that are awarded competitive grants receive an enhanced Medicaid matching rate to help eligible individuals transition from a qualified institutional setting to a qualified home or community based setting.

Demonstration Program to Improve Community Mental Health Services
Section 223 of the Protecting Access to Medicare Act created this demonstration program for States to implement from FYs 2017-2019.  The program provides an enhanced Federal Medicaid match rate for certified community behavioral health clinics with the aim of improving access to behavioral health services for Medicaid beneficiaries.

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• CMS Overview
• Children’s Health Insurance Program
• Medicaid
• Medicare
• Program Integrity
• Program Management
• State Grants and Demonstrations