Tag: Providers

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Governor signs bill that gives nursing homes $700 million funding boost

MM Curator summary

[MM Curator Summary]: More details on the plan to increase nursing home facility pay and continue the underlying provider “tax” mechanism used to pay for it all. Punchline- meet 70% of CMS staffing guidelines and get bonuses.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

 
 

Gov. J.B. Pritzker (D)

A $700 million Medicaid funding boost is coming to Illinois providers after Gov. J.B. Pritzker (D) on Tuesday signed nursing home reform legislation that ties the Medicaid increases to higher staffing levels. 

The legislation was specifically highlighted by top leaders at the Centers for Medicare & Medicaid Services earlier this year as it looks to better support states and implement new payment frameworks for providers. 

The measure was originally passed in April before being signed into law this week. Under the law, Illinois will increase its $2.5 billion in annual nursing home funding by roughly $700 million, with $100 million coming from the state and the rest from federal Medicaid and provider assessments. 

It also calls on nursing homes to meet at least 70% of federal staffing level guidelines in order to qualify for bonus reimbursements. Nursing homes’ star ratings also will be taken into consideration for reimbursement increases. 

Providers and resident advocates both have hailed the reform measure.

“Everyone deserves quality affordable healthcare,” Pritzker said Tuesday. “With [the] signing, Illinois will no longer tolerate an emphasis on profits over people, especially at the expense of our most vulnerable seniors.”

CMS Administrator Chiquita Brooks-LaSure in April said CMS is “moving in an additional direction to make sure the dollars that are being spent are going to direct care.”

New York also has pushed ahead with legislation that ties funding to direct care at nursing homes. The state in February passed legislation that requires providers to spend a minimum of 70% of revenue on direct care — with at least 40% of that going to direct care workers.

 
 

Clipped from: https://www.mcknights.com/news/governor-signs-bill-that-gives-nursing-homes-700-million-funding-boost/

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PA’s long-term care crisis and how a push to increase Medicaid reimbursements could help

MM Curator summary

[MM Curator Summary]: PA is struggling to deal with a flailing long-term care workforce.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

Dauphin County, PA — Pennsylvania has lost nearly 20% of its long-term care workforce since the pandemic started two years ago, according to the Pennsylvania Health Care Association.

The Association reports 11 nursing homes have shut down, including two in recent weeks. Officials say this is creating an access to care crisis. Nursing home providers have been turning away 20 seniors per month on average since December.

It’s a concern with the state’s aging population in mind. The Health Management Associates performed an independent study recently, identifying more than 1.18 million Pennsylvanians will need long-term care over the next 20-30 years.

“If nursing homes, personal care homes and assisted living communities continue to lose workers, who will care for our aging population?” Pennsylvania Health Care Association President and CEO Zach Shamberg said.

“Throughout the state, nursing homes are turning away someone’s parent, grandparent, aunt or uncle because there aren’t enough workers to care for more people,” Senate Aging and Youth Committee Chairwoma Sen. Judy Ward continued.

The Pennsylvania Health Care Association and some legislators are calling for a $294 million increase in the state’s Medicaid reimbursement to sustain a future for long-term care. They also want American Rescue Plan funds to support recruitment and retention.

Medicaid reimbursement hasn’t been increased in the state since 2014 and the rate currently falls about $50 short per resident per day.

 
 

Clipped from: https://local21news.com/news/local/pas-long-term-care-crisis-and-how-a-push-to-increase-medicaid-reimbursements-could-help

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Pritzker signs bill that helps Medicaid patients

[MM Curator Summary]: Headline should read: “Pritzker signs bill that keeps $3.9B in hospital Medicaid payments flowing.” Not exactly the same thing as “helps Medicaid patients.”

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

Gov Pritzker signs Hospital Assessment Program(WIFR Newsroom)

CHICAGO, Ill. (WIFR) – Governor JB Pritzker signed a bill Tuesday extending and expanding the Hospital Assessment Program in Illinois.

The current program, which signed into law in 2020, runs through the end of 2022. It brought additional funding and improved Medicaid responsiveness in areas of the state most affected by COVID-19.

This bill will help establish refined payment structures for each hospital class and maintain the existing assessment tax structure. The renewed Hospital Assessment program waives $240 million in the assessment imposed on hospitals. It also aligns hospitals with payment and Medicaid needs, as well as offering tax exemptions and waivers to help hospitals recover from the effects of COVID-19.

Pritzker commented Tuesday saying “The Hospital Assessment program was an important support to hospital’s critically in need of additional funding during the worst of the COVID-19 pandemic,”. He’s also optimistic about the impact of the bill, saying “This extension continues to support them on the path to recovery and offers expanded services and Medicaid support to more hospitals to ensure people across the state have access to affordable, high-quality health care.”

House Majority Leader Greg Harris says “The Hospital Assessment program brings an additional $3.9 billion dollars into Illinois’ Medicaid program”.

 
 

Clipped from: https://www.wifr.com/2022/05/17/pritzker-signs-bill-that-helps-medicaid-patients/

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Mental Health Bill Aims to Sync Substance Use, Medicaid Agencies

[MM Curator Summary]: A new federal bill would specify monies to enforce existing MH parity rules.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Mental health services would get a funding boost in bipartisan legislation set to be unveiled Tuesday that aims to improve coordination between agencies focusing on opioid addiction services and paying for treatment.

The measure, by Sens. Bill Cassidy (R-La.) and Chris Murphy (D-Conn.), would provide a path for ramping up existing health plans and coordination between the Substance Abuse and Mental Health Services Administration and the Centers for Medicare & Medicaid Services to better help individuals with serious mental illness.

According to a legislative overview document, the Mental Health Reform Reauthorization Act of 2022 would also authorize $25 million annually for five fiscal years for states to enforce existing mental health parity laws. The existing laws require that insurers cover mental health care to the same extent as other services.

Mental health has been a major focus for both parties in Congress as well as the White House, taking up much space in congressional hearings and administration policy pushes. House lawmakers on May 6 introduced legislation to reauthorize several federal health programs and require non-government plans to comply with mental health parity laws.

“I’m probably always willing to go further on parity, you know, enforcement than some Republicans are. And I’m always kind of sensitive to finding the middle ground when it comes to the way in which we enforce existing parity law,” Murphy told reporters last week.

Murphy also noted that “we’re sensitive to the appetite right now for a lot of new programs,” though noted skepticism from Sen. Richard Burr (R-N.C.) “about the utility of new programs.” Burr is the ranking member of the Senate Committee on Health, Education, Labor and Pensions, which deals with mental health matters.

The legislation would also re-up dollars for one of SAMHSA’s largest programs, the Community Mental Health Services Block Grant, and push for the CMS to coordinate better in serving young individuals earlier when they experience mental health troubles.

“Step by step by step, we want to make it so that the first psychotic episode a young person has is her last psychotic episode,” Cassidy said at a press event on the legislation.

Those eligible for SAMHSA grants to divert people with mental illness from incarceration would be protected from “destabilizing medication changes” under the bill, according to an overview document for the legislation. The bill would also support a SAMHSA program to help those suffering from mental illness and homelessness access housing.

 
 

Clipped from: https://news.bloomberglaw.com/pharma-and-life-sciences/mental-health-bill-aims-to-sync-substance-use-medicaid-agencies

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Contracted Medicaid Managed Care Providers Treated Few Beneficiaries

[MM Curator Summary]: The PAR rate is even worse than we thought.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Treatment from contracted Medicaid managed care providers was highly concentrated, with a quarter of physicians and specialists accounting for the majority of claims.

 
 

Source: Getty Images

 
 

By Victoria Bailey

May 04, 2022 – Around one-third of primary care and specialty physicians that contracted with Medicaid managed care plans saw fewer than ten Medicaid beneficiaries over a year, suggesting that network adequacy standards may not accurately reflect beneficiary access to physicians, a Health Affairs study found.

Over 70 percent of Medicaid beneficiaries are enrolled in managed care plans, which are responsible for constructing physician networks from which beneficiaries can seek care. Physician networks in Medicaid managed care plans are typically similar to those in private plans offered through the state health insurance market.

However, network directories may be out of date or list physicians that are not willing to treat Medicaid beneficiaries, indicating that the networks may not reflect the actual availability of physicians. In addition, beneficiaries may prefer providers not included in the network.

To understand how accurate Medicaid managed care plan networks are in determining the availability of physicians for Medicaid beneficiaries, researchers gathered administrative medical claims, Medicaid eligibility and enrollment files, and provider network directories for managed care plans in Kansas, Louisiana, Michigan, and Tennessee between 2015 and 2017.

There were around 22,000 physicians in adult primary care, pediatric primary care, cardiology, and psychiatry in Medicaid managed care networks across the four states, the study found.

About 16 percent of the physicians saw zero Medicaid beneficiaries over one year—defined as ghost physicians. Psychiatrists were the most likely to be ghost physicians, with 35.5 percent treating no Medicaid beneficiaries. Pediatric primary care physicians were least likely to be ghost physicians (11 percent).

Similarly, 17 percent of physicians treated between one and ten Medicaid beneficiaries and were classified as peripheral physicians. Nearly 43 percent of providers saw between 11 and 150 beneficiaries (standard physicians), while 23.7 percent of providers treated more than 150 beneficiaries within a year (core physicians).

The majority of physicians (87.8 percent) who provided care to Medicaid beneficiaries were contracted with Medicaid managed care plans, but 2,500 out-of-network physicians treated at least one Medicaid beneficiary. This suggests that there is a small level of care available to beneficiaries outside the physicians listed in network directories.

Treatment from physicians included in Medicaid managed care plan networks was highly concentrated among small percentages of physicians.

For example, among pediatric and adult primary care physicians that treated at least one Medicaid beneficiary, 25 percent of physicians were responsible for 86.2 percent of claims. Additionally, a quarter of cardiologists accounted for 69.2 percent of claims and 25 percent of psychiatrists were responsible for 86.5 percent of claims.

Among physicians who treated more than 150 Medicaid beneficiaries, 29 percent of primary care physicians accounted for 88 percent of care, 22 percent of cardiologists provided 632 percent of the care, and 15 percent of psychiatrists were responsible for 70.6 percent of care.

Care concentration was slightly higher in urban areas compared to rural areas, the study noted.

Network adequacy requirements vary across the 20 states that have them. Some require plans to contract with at least one primary care provider for every 100 beneficiaries, while others require one provider for every 2,500 beneficiaries.

Based on these network adequacy standards, 94.2 percent of the counties in the four states included in the study had sufficient access to primary care physicians, with an average of one primary care physician for every 440 beneficiaries.

Across the four states, 12.4 percent of counties met the standard for cardiologists, while 10.4 percent met the standard for psychiatrists. After excluding ghost and peripheral physicians, these figures decreased for each provider group.

“Our findings suggest that provider network directories may overstate the availability of physicians in the Medicaid program; many states’ reliance on directories to ensure network adequacy may be insufficient to ensure satisfactory access to physicians who are both valued by Medicaid managed care beneficiaries and willing to treat them,” the researchers wrote.

Medicaid managed care plans are required to demonstrate the adequacy of their networks, but federal leaders have not provided much oversight on how to do this, the study noted. In addition, state network adequacy standards and enforcement vary widely.

Researchers suggested two policy solutions to improve the oversight of Medicaid provider networks. First, states should direct resources to regularly evaluate managed care networks through a combination of audit studies and administrative claims data.

Additionally, states should enact strict penalties for managed care plans that do not comply with network adequacy standards.

 
 

Clipped from: https://healthpayerintelligence.com/news/contracted-medicaid-managed-care-providers-treated-few-beneficiaries
 

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PSD rejoining Colorado’s Medicaid reimbursement program

[MM Curator Summary]: A CO school will re-sign up to get Medicaid funding for healthcare services after a 10 year break and starting a new plan on how to manage the funding stream.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

After a hiatus of more than a decade, Poudre School District is rejoining Colorado’s Medicaid reimbursement program for school districts. Through the program, PSD will receive partial reimbursements from the state for the cost of providing Medicaid-eligible health services to some students. 

Reimbursements to PSD will be based on the cost of delivering services given by eligible service providers — including nurses, social workers, health aides, occupational therapists and more — but it is not limited to services provided to students who are enrolled in Medicaid individually. Rather, the program partially reimburses health services provided to general education students who qualify through certain health or behavioral plans. 

The program will serve as “a sustainable source of funding that supports the enhancement and expansion of mental and physical health services in schools,” according to a presentation recently given to the Board of Education.

The money the district receives in reimbursements must be spent on health services for all PSD students, not just those who receive the reimbursement-eligible services. This shift is something PSD spokesperson Madeline Noblett said was one of the main reasons the district wanted to join the program again now. 

“We’re really looking at this as an opportunity as a district to be able to grow revenue to support all of our students,” she said, adding that the “mental, social, emotional (and) academic needs of kids have increased.”

“Our needs have continued to increase every year, and our staff are doing incredible work, but they are stretched thin, and they’re supporting so many kids … So we’re constantly just looking to see what the resources available to us are that we may not already be tapping into.”

Though PSD’s new Medicaid Coordinator Corey Henry said they haven’t yet determined what this money will be spent on, it can be used for things such as hiring additional nurses or mental health staff, getting more equipment or engaging with outreach workers to connect families to their needs. A requirement of the program is that the district form a team to assess its needs and how best to spend the money. 

Currently, PSD has just 14 nurses for its 53 schools, according to Kim Granger, health services coordinator.  

“It just feels like the right thing to do to not leave money on the table when we’re (already) providing the services,” Granger said. “It was kind of a no-brainer in my mind.”

How are PSD students doing?:From attendance to social emotional skills, here are 5 takeaways from PSD’s annual report

PSD was most recently a participant in the Medicaid program in 2009. In the 2016-17 school year, former Superintendent Sandra Smyser considered rejoining the program but ultimately put it on hold.

Noblett said that back in 2009, the district left the program because leaders felt it wasn’t “as expansive as possible for the ultimate amount of money that we were generating as a district.” 

However, the program has since started using a cost reconciliation method to calculate reimbursements and, in 2020, it expanded to include reimbursement for Medicaid-eligible health services to more students. Prior to that change, the program allowed reimbursement based on care given to students with individualized education plans or individualized family service plans, but it now includes students with 504 plans, behavior intervention plans and other health care plans, Noblett said.

These changes streamlined the program and allowed districts to claim more costs for the health services they provide to students, according to district officials. 

For subscribers:31 charter schools closed in the last decade. Still, school choice demand is peaking.

When will the program be in place?

PSD expects the program will be fully in place by Oct. 1 this year, but it won’t see regular revenue to cover the initial investment costs for about three years. The only initial investment required by PSD was the cost to fund Henry’s position and an administrative assistant to help get the program running.

Though district officials cannot predict the exact amount of money it will bring in annually until closer to that three-year mark, neighboring districts and those of similar size have received anywhere from $1.2 million to $2.5 million.

Over the summer, Henry and her implementation team will work to create training schedules for staff, have orientation for administrative teams and begin program training in August and September.

Henry and Granger expect that the biggest change for current PSD providers will be the kind of documentation required to access the reimbursement money, though it’s too early to know what the day-to-day lift will look like. 

“There will be some (service providers) with larger caseloads that will probably have more time to spend on their documentation, and some of that won’t take as much time as they think,” Granger said. “I think there’s a ton of fear out there that it’s going to take a huge amount of time, (but) the program is different than what they knew before.”

In the meantime, the biggest lift for Henry and her team will be supporting the staff throughout training and ensuring they understand their roles in the program moving forward. 

“We’re really hoping to make this as successful as possible, build a program where staff feels supported through training, have clarity around what their work looks like as service providers and really, again, generate money that PSD has not been accessing so that we can help our students,” Noblett said. 

PSD news:Liberty Common Elementary School announces expansion, likely into former charter building

Molly Bohannon covers education for the Coloradoan. Follow her on Twitter @molboha or contact her at mbohannon@coloradoan.com. Support her work and that of other Coloradoan journalists by purchasing a digital subscription today.

 
 

 
 

Clipped from: https://www.coloradoan.com/story/news/2022/04/26/psd-rejoining-colorados-medicaid-reimbursement-program/7374814001/

 
 

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Medicaid to utilize centralized credentialing process for managed care providers this summer

[MM Curator Summary]: LA will implement a single provider enrollment and credentialling system across all MCOs.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

First-year implantation phase to begin in July for fee-for-service provider screenings. 

The Mississippi Division of Medicaid plans to implement a centralized credentialing process for managed care providers enrolling in MississippiCAN or Children’s Health Insurance Program (CHIP) coordinated care organizations (CCOs).

This is part of an on-going effort to cut down on red tape and reduce administrative overhead for health care providers.

 
 

Drew Snyder, Director of the Division of Medicaid

“The Division has made it a priority to better understand the challenges voiced by providers and sought to work together toward meaningful change in support of our shared goal of better outcomes for beneficiaries,” said Drew Snyder, executive director. “Streamlining provider credentialing will be a huge step toward focusing on patients instead of processes, and we are grateful to the Legislature and provider community for their partnership on this initiative.”

The implementation will take place over 12 months beginning in July of 2022. Providers will follow the DOM’s current screening process to qualify for Medicaid fee-for-service and MississippiCAN. This will allow for immediate admin relief and will not jeopardize health plan accreditation if approved by the National Committee for Quality Assurance (NCQA).

There are three CCOs administering MississippiCAN: Magnolia Health, UnitedHealthcare Community Plan, and Molina Healthcare. CHIP is administered by Molina Healthcare and UnitedHealthcare Community Plan.

Providers who wish to enroll in those networks are required to complete a separate credentialing process with each plan to verify that they are qualified providers. Additionally, they must undergo re-credentialing every three years to ensure their information is still accurate and up to date.

The traditional “credentialing” process, which is required of all health plans by NCQA is lengthy and often requires the submission of additional documentation and related paperwork. Also, providers must currently credential with multiple entities as described above.

Through bills from the Legislature the DOM is able to simplify the operation by enabling providers to credential through one single avenue that will not only qualify them, but allow them to contract with any CCO. DOM screens providers enrolling in fee-for-service Medicaid but has not been required to credential.

When the implementation period ends on June 30, 2023, providers will have a centralized hub for credentialing in Medicaid-related benefit programs.

 
 

Clipped from: https://yallpolitics.com/2022/04/18/medicaid-to-utilize-centralized-credentialing-process-for-managed-care-providers-this-summer/

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Nearly 2,000 providers to receive $503M in Medicaid grants

[MM Curator Summary]: The FL HCBS ARPA money is finally moving to providers.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

Florida Medicaid officials are distributing nearly $503 million in enhanced payments to 1,945 providers that render community- and home-based services to the poor, elderly and disabled, the administration of Gov. Ron DeSantis announced Tuesday.

That’s about $180 million less than what the Agency for Health Care Administration initially said would be made available last year when the agency announced the availability of the funds and encouraged home- and community-based service providers to apply for the supplemental payments. The funding was made possible by the American Rescue Plan, pushed by President Joe Biden.

The state did not offer a list of the providers that will be receiving the money. Instead, the state is sending emails to the providers notifying them of whether their requests were accepted and to “provide instructions on next steps.”

AHCA told Florida Politics Tuesday the state is reopening the window of opportunity for providers that use 1099 staff to submit applications for the funds. Those providers will have until May 20 to submit a grant application to the state. The $180 million will be used to help fund those new grant applications.

It will also be used to fund $12 million in delayed egress grants. Those grant awards were not announced Tuesday.

 
 

If necessary, some of the $180 million can also be used to adjust grant applications that were erroneously rejected or wrongly calculated, AHCA said.

“From the beginning of his administration, Gov. DeSantis has led the charge amongst the nation’s Governors in putting Florida’s seniors and most vulnerable first,” AHCA Secretary Simone Marstiller said in a prepared release.

“The agency is pleased to award this enhanced funding to Florida’s home- and community-based services providers who are working hard to address record increases in operational costs and challenges in recruiting and retaining staff.”

Florida’s home- and community-based Medicaid providers have been waiting for weeks for word about the grant awards. The state on Feb. 15 told the federal government it wanted to have the money distributed by the end of March.

AHCA Communications Director Brock Juarez defended the agency’s work to get the money distributed.

 
 

“From the onset of the (home and community based) enhanced funding program, AHCA has been at the front of states in applying and administering this funding to mitigate the impacts of inflation and workforce capacity to support HCBS providers, who provide care for some of the most vulnerable Floridians,” Juarez said in a statement to Florida Politics. “We are proud of the hard work and dedication of our team to process over 2,000 applications and award over a half billion grant funding in only two months’ time.”

The agency announced late last year it would award $1.2 billion in supplemental payments in two rounds. More than $680 million was made available during the first round of funding, and the state accepted applications between Dec. 17, 2021, and Feb. 14, 2022. The money was divided into three silos: $405 million in grants for one-time provider stipends, $266.6 million for retaining employees and recruiting new ones, and $12 million for delayed egresses.

Ninety three percent of the approved grant applications requested funds from more than one silo.

Juarez said the money would be first distributed to providers who worked with Medicaid iBudget Waiver clients, followed by those who work with Medicaid managed long-term care clients.

The iBudget waiver program, administered by the Agency for Persons with Disabilities (APD), provides people with intellectual and developmental disabilities access to services that keeps them out of institutions and living in the community.

“The foundation of this funding plan builds on APD’s dedication to ensuring that vulnerable Floridians have the resources they need to thrive in their communities,” APD Secretary Barbara Palmer said in a prepared release. “These funds will make a huge difference to attract qualified applicants to serve our vulnerable customers.”

The state will rely on the contracted Medicaid managed long-term care plans to distribute the enhanced payment to the home- and community-based services providers they contract with. The Medicaid managed long-term care program allows people who qualify for nursing home placement to forgo institutional care and choose to receive home- and community-based services instead.

Clipped from: https://floridapolitics.com/archives/517612-nearly-2000-providers-to-receive-503m-in-medicaid-grants/

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Providers still waiting for state to deliver $1.2B in supplemental Medicaid funds

[MM Curator Summary]: Zero dollars and zero cents of the $1.2B Florida took from ARPA have been distributed to providers more than 6 months months after the funds made it to state coffers.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

In an effort to bolster the state’s home- and community-based services network, the Gov. Ron DeSantis administration late last summer agreed to tap into $1.2 billion in additional federal Medicaid funds.

More than six months later, the state hasn’t distributed any of the supplemental funds and providers don’t know when to expect the payments. They also don’t know how much to expect because the state did not finalize the distribution formula it was going to use to disburse the funds.

Attain Inc. has taken out two small business loans since September when the state announced it received approval from the federal government to use the funds, said Craig Cook, executive director of the not-for-profit agency that has been providing residential services to people with disabilities in central Florida since 1988.

The loan money, Cook said, is being used to cover deficit spending, the result of years of stagnant Medicaid reimbursement rates and a tight long-term care labor market that was made worse by the COVID-19 pandemic.

“We were given hope,” Cook said of the supplemental Medicaid payments. “But now, it’s like there’s no help at this point, because nothing is being realized.”

 
 

Cook, and many other providers like him, thought that the state would have distributed the supplemental payments by now. And according to documents submitted to the federal government, the state intended to have the payments distributed by winter 2022.

Agency for Health Care Administration Communications Director Brock Suarez did not comment on why the funds were delayed.

Cook’s application for funds was one of more than 2,400 received by the agency before the Feb. 14 deadline.

The agency announced late last year it would award the supplemental payments in two rounds. More than $680 million was made available during the first round of funding and the state would accept applications between Dec. 17, 2021 and Feb. 14, 2022.

The money was divided into three silos: $405 million in grants for provider stipends, $266.6 million for retaining employees and recruiting new ones, and $12 million for delayed egresses.

 
 

Providers could apply for funds from more than one silo.

And they did.

Of the more than 2,400 applications received, 89% of them were for one-time stipends and 82% of the applications were for retention funds. That’s according to Kristin Sokoloski, a Medicaid program coordination administrator.

Sokoloski told members of a Medicaid medical advisory committee that assisted living facilities, home- and community-based service providers, home health agencies and case management agencies qualified for supplemental Medicaid funds during the first round of funding.

The majority of the applications received, 70%, were submitted by home- and community-based providers. Of those providers, 70% worked with people enrolled in the Medicaid iBudget Waiver program, according to Sokoloski’s presentation to the committee.

Jim DeBeaugrine is the former director of the state Agency for Persons with Disabilities and currently is a lobbyist for a spate of clients that provide services to people with intellectual and developmental disabilities. That includes The ARC of Florida.

“They are definitely very interested in these funds and a lot of these guys are barely hanging on,” DeBeaugrine said. “The quicker this can get out there, the better.”

The DeSantis administration moved last summer to take advantage of a 10% bump in federal Medicaid dollars available under the American Rescue Plan Act.

Most Florida Medicaid patients who receive home- and community-based services are either enrolled in the Medicaid managed long-term care program or the Medicaid iBudget program.

The former is for frail and elderly individuals who qualify for nursing home placement but choose to receive assistance with daily living activities, such as eating and dressing, that enable them to continue to live in their homes or another non-institutional setting.

Similarly, the Medicaid iBudget Waiver program allows adults with intellectual and developmental disabilities to tap into the home- and community-based services they require to continue living outside of an institution and in their family home or a group home.

Tyler Sununu is the president and CEO of the Florida Association of Rehabilitation Facilities, an association that represents facilities that treat people with intellectual and developmental disabilities.

“Providers are asking me every day for an update,” Sununu said about the additional payments. “The bottom line is providers really need the money and I’m very hopeful that if not this week, next week we’ll see some of that.”

The agency is supposed to announce a second round of funding opportunities sometime this month.

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Clipped from: https://floridapolitics.com/archives/516083-providers-still-waiting-for-state-to-deliver-1-2b-in-supplemental-medicaid-funds/

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US hospitals with the highest share of patients on Medicaid

[MM Curator Summary]: NYC has 8 of the top 10, despite not being ranked in any list of cities with highest poverty.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Becker’s calculated which U.S. hospitals have the highest share of their patients covered under Medicaid.

Eight of the 10 highest-ranked hospitals are public facilities located in New York City.

The 2019 data released April 5 is from the coverage, cost and value team at the National Academy for State Health Policy in collaboration with Houston-based Rice University’s Baker Institute for Public Policy.

 
 

Hospitals with the highest percentage of Medicaid in their payer mix:

 
 

(1) Queens Hospital Center — 96 percent

Location: New York City

Beds: 200

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(2) Laguna Honda Hospital — 94 percent

Location: San Francisco

Beds: 6

System: San Francisco Health Network

Ownership type: public

 
 

(3) Lincoln Medical & Mental Health Center — 94 percent

Location: New York City

Beds: 287

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(4) Kings County Hospital Center — 89 percent

Location: New York City

Beds: 406

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(5) Woodhull Hospital Center — 86 percent

Location: New York City

Beds: 238

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(6) Metropolitan Hospital Center — 85 percent

Location: New York City

Beds: 196

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(7) North Central Bronx Hospital — 84 percent

Location: New York City

Beds: 130

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(8) Elmhurst Hospital Center — 83 percent

Location: New York City

Beds: 358

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(9) Bellevue Hospital Center — 82 percent

Location: New York City

Beds: 527

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(10) Pacifica Hospital of the Valley — 81 percent

Location: Los Angeles

Beds: 133

System: independent

Ownership type: for-profit

 
 

(11) Kensington Hospital — 81 percent

Location: Philadelphia

Beds: 31

System: independent

Ownership type: for-profit

 
 

(12) College Hospital Costa Mesa — 80 percent

Location: Costa Mesa, Calif.

Beds: 122

System: independent

Ownership type: for-profit

 
 

(13) Coney Island Hospital Center — 78 percent

Location: New York City

Beds: 292

System: New York City Health and Hospitals Corp.

Ownership type: public

 
 

(14) East Los Angeles Doctors Hospital — 78 percent

Location: Los Angeles

Beds: 102

System: Avanti Hospitals

Ownership type: for-profit

 
 

(15) Red Bud Regional Hospital — 77 percent

Location: Red Bud, Ill.

Beds: 25

System: independent

Ownership type: for-profit

 
 

Clipped from: https://www.beckershospitalreview.com/finance/us-hospitals-with-the-highest-share-of-patients-on-medicaid.html