Comment letter CMS TCM PR 5.29.09

National Association of Area Agencies on Aging 1730 Rhode Island Avenue, NW, Suite 1200 / Washington, DC 20036 / Tel: 202-872-0888 / Fax: 202-872-0057 / www.n4a.org May 29, 2009 Ms. Charlene Frizzera Acting Administrator Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services Ms. Cindy Mann Director of the Center for Medicaid and State Operations P.O. Box 8010 Baltimore, Maryland 21244-8010 Attention CMS-2287-P2 Dear Acting Administrator Frizzera and Director Mann: The following comments by the National Association of Area Agencies on Aging are in response to the partial rescission of the targeted case management Interim Final Rule (IFR) (CMS-2237-IFC) posted in the Federal Register on May 6, 2009. While we appreciate that CMS has recognized the IFR on targeted case management services “may unduly restrict beneficiary access to needed covered case management services, and limit States flexibility in determining efficient and effective delivery systems for case management services,” we remain very concerned that the new proposed rule does not address several issues n4a raised in its January 29, 2008 comment letter to CMS (see attachment). We remain very concerned that the new definitions and requirements under the IFR would apply more broadly to Medicaid as a whole, which could adversely impact 1915(c) state waiver programs, Money Follows the Person demonstration grant initiatives, and ...