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Medicare to Start Paying Doctors Who Coordinate Needs of Chronically Ill Patients
August 16, 2014August 16 – In a policy change, the Obama administration is planning to pay doctors to coordinate the care of Medicare beneficiaries, amid growing evidence that patients with chronic illnesses suffer from disjointed, fragmented care.
Report Discusses Consequences of Not Expanding Medicaid
August 15, 2014August 15, 2014 – The Robert Wood Johnson Foundation and the Urban Institute released a brief highlighting the financial repercussions for the 24 states that have not expanded Medicaid. Deciding not to expand Medicaid, these states will collectively forgo $423.6 million in federal funding, and leave 6.7 million uninsured.
Still No Word on IN Republicans’ Alternative Medicaid Plan
April 15, 2014April 15, 2014 – Indiana Republican Gov. Mike Pence and Republican state legislators are hopeful that their alternative plan to traditional Medicaid expansion is still being considered by the Administration despite Secretary Sebelius’ recent resignation. The Governor has not heard from the Administration on this matter since he met with the former secretary in February 21. Gov. Pence had sent Secretary Sebelius a follow up letter on March 4.
Corbett plan will test federal agency on Medicaid
April 14, 2014April 14, 2014 – Accompanying Corbett’s proposal is a request to pare the existing Medicaid program for adults, including limiting hospital admissions, medical supplies and radiology procedures such as MRIs, CT scans and X-rays. That, Alker said, has nothing to do with the purpose of a waiver, and it is possible CMS tells Corbett to request those changes separately.
Kansas Senate Approves Prompt Pay Bill
March 26, 2014March 26, 2014 – H.B. 2552 would provide a cause of action for providers who are not promptly paid by KanCare’s MCOs. Providers will be able to assess a 12% fee each month that payment is not fully paid. The bill follows another such bill, S.B. 317, that stalled in the Senate in February.
Massachusetts Receives $110.6 Million Grant to Expand HCBS
March 25, 2014March 25, 2014 – The $110.6 million grant from the Centers for Medicare and Medicaid Services (CMS) stipulates that Massachusetts must spend at least 50 percent of their federal funds on home and community-based services (HCBS). Specific use of the funds will be determined in the coming months. This follows the Governor’s FY 2015 budget which expands the Commonwealth Home Care Program by $16.9 million, as well as the Governor’s proposal to expand Massachusetts’ Supportive Housing Program from 31 to 41 sites.
Advocates Push for Amendment Banning HCBS Cuts in Louisiana
March 18, 2014March 18, 2014 – Home and community-based services (HCBS) advocates are pushing for a constitutional amendment in Louisiana that would prevent rate reductions for HCBS and hospice. Similar constitutional amendments for hospital and nursing homes/intermediate care facilities will be presented to voters in the fall.
Kansas Officials Cleaning Up HCBS Waitlists
March 14, 2014March 14, 2014 – Last week, Kansas sent letters to around 2,600 physically disabled, stating that if they did not reply by June 30 indicating an interest in receiving services, they would be taken off the wait list. The physical disability waiver currently has 5,515 beneficiaries, and Kansas is attempting to raise that capacity to 5,900.
News
March 6, 2014Elder Abuse Bills Gain Traction in Georgia and Iowa
February 17, 2014 – In Georgia, a House panel approved a bill that would increase the first offense of operating an unlicensed personal care home from a misdemeanor to a felony. In Iowa, a bill would provide emergency orders and resources and referrals for elderly abuse victims.
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California Replaces Sanctioned Plans for Duals Demo
February 14, 2014 – Two of California’s duals plans had been sanctioned this year by CMS, one because of marketing and enrollment issues, and the other because of quality issues. California has managed to substitute the two contractors with three. The revised start date for the Duals Demo, though previously delayed numerous times, remains at April of this year.
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North Carolina Paying Millions in Consulting Fees to Revamp Medicaid
February 14, 2014 – One consultant contract, for $3.25 million, provides for a reorganization of NC’s Medicaid department, while the second, at almost $500,000, seeks to assess the state’s fraud and audit capabilities and provide recommendations in that space.
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Florida MCOs Transitioning Enrollees from Nursing Homes to Home Care
February 10, 2014 – Sunshine Health, one of seven of Florida’s Medicaid MCOs, has transitioned 163 Medicaid enrollees from the nursing home. Seventy of those have been transitioned to home care. Florida is in the process of transitioning 45,000 nursing home residents and 40,000 home care and assisted living facilities residents to managed care.
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New York Times Profiles MLTSS Shortcomings
March 6, 2014March 6, 2014 – The New York Times discusses the negative impacts of cost containment in managed long term services and supports (MLTSS) programs in Tennessee, New York, Wisconsin, and Minnesota.