Description: Rhode Island’s unique “global Medicaid waiver” pursues a potentially dangerous national policy trend: long-term care LTC rebalancing without strong eligibility controls. Resulting cost overruns could seriously damage the state’s social safety net. To maximize the global waiver’s opportunity, minimize its danger, and become a LTC financing model for the country, policy makers need to recognize the issues discussed in this report and pursue the recommended additional research and analysis.

Description: This article provides some state officials' responses to a request for information from legislators related to the study and reform of Medicaid long-term care (LTC) eligibility and estate recovery rules. In those replies, there is strong evidence that Medicaid eligibility and estate recovery rules are subject to frequent and egregious abuses.