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Objective 1: Increase the number of participants accessing healthcare by five percent (5%) each demonstration year, not to exceed six-thousand (6,000) enrollees.

Objective 2: Reduce the number of inpatient hospitalization admissions for participants by five percent (5%) each demonstration year.

Objective 3: Reduce the number of emergency department (ED) visits for participants by five percent (5%) each demonstration year.

Objective 4: Reduce the number of admissions to long-term care (LTC) nursing facilities for participants by five percent (5%) each demonstration year.

The Proposed Health Care Delivery System and Eligibility Requirements The Division of Medicaid’s HMW operates statewide. Applicants who meet the following criteria will be enrolled in the waiver:

• Individual is over 65 years of age or meets the SSI disability definition, • Individual does not have Medicare, • Income is below 135% of FPL, • Resources remain under $4,000 for an individual or $6,000 for a couple, and • Individual is not otherwise eligible for any State Plan category of eligibility, CHIP or other waiver.

When the individual becomes eligible for Medicare he/she will no longer qualify for the HMW. The individual’s file will be reviewed to see if he/she can qualify for another Medicaid category of eligibility.

The Aged, Blind and Disabled (ABD) Application for the HMW is a fillable PDF form that can be accessed at www.medicaid.ms.gov. The completed application can be faxed to (601) 576-4164, emailed to application@medicaid.ms.gov, or delivered to the Regional Office serving the applicant’s county of residence. Individuals may also call the Division of Medicaid toll-free at 1-800-421-2408 or contact a Regional Office to request an application be mailed. An in-person interview is not required, but can be conducted if requested. Effective March 1, 2014, IRS rules for Modified Adjusted Gross Income (MAGI) are used to determine a household’s income.

The Proposed Benefit Package and Cost Sharing HMW covers all Medicaid State plan services except for the following: • Swing bed in a skilled nursing facility, • Long-term services and supports (nursing facility, home and community-based waiver and intermediate care facility for individuals with intellectual disabilities (ICF/IID) services), and • Maternity and newborn care. There are no required premiums, co-payments or deductibles for children enrolled in the HMW. Cost-sharing for adult enrollees is consistent with the Medicaid State plan. A family’s total annual out-of-pocket cost sharing cannot exceed five percent (5%) of the family’s gross income.