Tag: State News

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Illinois Sets Aside $66 Million for Medicaid Innovation Collaborative

[MM Curator Summary]: Tech providers and FQHCs will get funding to address SDH in Illinois.

 
 

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.

 
 

The state funding will go to OSF HealthCare and four federally qualified health centers that have launched a five-year program to develop new technology platforms and services to help underserved communities access healthcare.

Illinois is spending almost $66 million on a new program aimed at helping underserved communities access care.

The state’s Department of Health and Family Services is funding Peoria-based OSF HealthCare and a group of federal qualified health centers (FQHCs) that have launched the Medicaid Innovation Collaborative (MIC). The MIC will use the money to develop innovative new technologies and services that help people struggling with social determinants of health, such as financial issues, housing and food insecurity, which affect how they access healthcare.

“We learned during the pandemic that virtual care was a game-changer for patients, and the new funding will help us implement the latest technologies to expand access to care for underserved communities and vulnerable populations,” Michelle Conger, CEO of OSF OnCall Digital Health, said in a press release. “As a leader in digital health, we are excited to develop, implement and evaluate innovative, evidence-based strategies that will improve health and wellness for all residents in the communities served by OSF and our partners, regardless of their income level or where they live.”

Healthcare organizations across the country are using digital health platforms to address those barriers to care often found in Medicare and Medicaid populations. Without that access, consumers often avoid or skip needed healthcare services, exacerbating chronic conditions, reducing healthy lifestyles and leading to costly healthcare services and reduced clinical outcomes down the road.

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OSF OnCall, the health system’s digital health platform, will be working with four FQHCs – Heartland Health Services in Peoria, Chestnut Health Systems in Bloomington, the Eagle View Community Health System in Oquawka, and Aunt Martha’s Health & Wellness in Danville – to equip community health workers and medical care teams with digital health tools to help assess and treat patients, including giving them resources and access to virtual care opportunities.

Those services will include chronic care management, behavioral health treatments, maternal and child health services, cancer screenings, and dental services. In addition, the program will support additional staff at community health clinics, EHR implementations, mobile health units and digital health connectivity in underserved areas.

The project will also create about 100 new healthcare jobs, potentially affected about a third of the state. The MIC is partnering with Illinois Central College in East Peoria to train people to fill those community health worker positions.

Officials says the program’s goal is to provide 1 million episodes of care for Medicaid patients over the next five years, especially targeting the state’s most vulnerable and marginalized communities.

 
 

Clipped from: https://www.healthleadersmedia.com/innovation/illinois-sets-aside-66-million-medicaid-innovation-collaborative

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California to eliminate Medicaid waitlists through assisted living waiver

[MM Curator Summary]: CA is using American Rescue Plan funds to add 7,000 new “slots” for its assisted living waiver program that helps disabled members stay in their community home-like setting.

 
 

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.

 
 

 
 

(Credit: Getty Images)

In an effort to eliminate waiting lists, California’s Medicaid program is adding 7,000 additional slots to its assisted living waiver program through 2024. 

The federal Centers for Medicare & Medicaid Services in January approved a home- and community-based assisted living waiver amendment at the request of the California Department of Health Care Services. The approval is retroactive to July 1, 2021, and runs through Feb. 28, 2024.

The assisted living waiver offers Medi-Cal eligible beneficiaries the choice of residing in an assisted living setting as an alternative to long-term placement in a nursing facility. The goal of the waiver is to transition eligible older adults and individuals with disabilities from a nursing facility to a community home-like setting in residential care facilities, adult residential care facilities or public subsidized housing.

California Assisted Living Association President and CEO Sally Michael said that eliminating the Medicaid waitlists will enable more people to receive care in the appropriate setting. She added that CALA also supported previous efforts to increase the reimbursement rate to reflect increasing minimum wages.

As of November 2021, 5,790 individuals were enrolled in California’s assisted living waiver program, and there were 6,559 on the waitlist.

The California Department of Health Care Services intends to fund the assisted living waiver expansion through the enhanced Federal Medical Assistance Percentage available through the American Rescue Plan Act.

Congress provided states with temporary enhanced federal funds for Medicaid HCBS through the American Rescue Plan Act, passed in March 2021. ARPA included $195.3 billion for state governments to use at their discretion. The dollars have maximum flexibility, with states encouraged to direct funding for COVID-19 mitigation efforts and to support industries hardest hit by the crisis.

Some states have used ARPA funding to provide relief to the senior living sector, including Michigan, Minnesota, Montana, New Jersey and North Carolina.

 
 

Clipped from: https://www.mcknightsseniorliving.com/home/news/california-to-eliminate-medicaid-waitlists-through-assisted-living-waiver/

 
 

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GA- The Down Syndrome Association of Atlanta on Medicaid waivers

[MM Curator Summary]: Governor Kemp is adding $6.6 million to add 325 “slots” for 2 GA I/DD waivers.

 
 

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.

 
 

 
 

ATLANTA — Monday marks World Down Syndrome Day and one Atlanta organization is asking its social media followers for help.

The Down Syndrome Association of Atlanta and the Georgia Council on Developmental Disabilities partnered together on March 21 to advocate for more waivers for the New Options Waiver Program (NOW) and Comprehensive Supports Waiver Program (COMP).

The non-profit posted their initiative on their social media urging people to email their state legislators asking them to address the NOW and COMP waiver waitlist.

These Medicaid waivers provide financial help to people with intellectual, developmental, or physical disabilities. They help pay for home and community-based services for people with developmental or intellectual disabilities who could otherwise be routed into institutional care.

According to the Georgia Council on Developmental Disabilities, there are more than 7,000 people on the waitlist for a Medicaid waiver in Georgia.

Happy World Down Syndrome Day! 🥳 Today we need your voice and just 2 minutes of your time! Email your state legislators…

Posted by Down Syndrome Association of Atlanta on Monday, March 21, 2022

Recent moves to offer more funding for made by Gov. Brian Kemp include his $2 million proposed budget for 100 new slots in the Medicaid waitlist. The number was then raised to $6.6 million for 325 slots in the House during Crossover Day on March 15. The new spending plan starts in July. 

The GCDD called the 325 new slots passed in the House “the largest increase in waiver spots in many years,” according to their partnership announcement with DSAA.  

Leading up to World Down Syndrome Day the nonprofit launched its $21 for 21 Days Campaign. Each day for 21 days, DSAA highlighted individuals with Down Syndrome and urged followers to donate $21 dollars.

According to the World Down Syndrome Day website, the date for WDSD being the 21st day of the 3rd month was selected to signify the 21st chromosome which causes Down syndrome.

To learn more about the NOW/COMP Waivers click here. 

 
 

Clipped from: https://www.11alive.com/article/news/local/down-syndrome-association-of-atlanta-state-legislators-adressing-now-comp-waivers/85-b853a0dc-bbf4-4010-9114-0509bf1e4658

 
 

   
 

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Texas Feud Over Medicaid Is Costing $7 Million A Day

[MM Curator Summary]: TX providers are losing $7M a day because of the decision by the Biden CMS to un-approve its DSRIP waiver.

 
 

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.

 
 

Since last year, Texas and Joe Biden’s White House have been in a Medicaid funding feud that has been costing Texas hospitals about $7 million a day. State and federal officials have imposed a deadline over the dogfight for this Friday. 

Last April, the Biden administration revoked a 10-year waiver renewal approval of billions in future Medicaid dollars for Texas.

According to The Houston Chronicle, the money, funneled through an 1115 waiver, has brought more than $30 billion to Texas since 2012, accounts for nearly one third of the state’s Medicaid budget, and funds emergency care to patients without government or private insurance.

After being denied the waiver, Republican state leaders sued to reinstate it. A federal judge ordered both sides to negotiate. A year later, they still have nothing to show for it, except the loss of millions of dollars.

Under the initial plan, payments to hospitals would have already begun, but instead, the stalemate is costing hospitals $7 million dollars a day and could force some to roll back medical services or increase charges if the waiver expires this fall, according to John Hawkins, President and Chief Executive of the Texas Hospital Association.

Since the Biden administration’s reversal last year, hospital and patient advocates assumed the waiver would shrink as Texas expanded Medicaid under the Affordable Care Act. Since Republicans have refused to expand, millions of low-income Texans are left without Medicaid or any other coverage.

Texas has both the biggest uninsured population and the highest uninsured rate of any state. The state also has historically low reimbursement rates for providers, including hospitals.

Sarah Rosenbaum, a health law and policy professor at George Washington University, said it’s possible that federal officials are trying to pressure Texas into contributing more toward indigent care.

“They’re now in a game of chicken with the administration,” Rosenbaum said of the state’s position.

The Centers for Medicare and Medicaid Services said the agency is “committed to ensuring a strong and vibrant social safety net across the nation, including in Texas.”

“This includes making sure that providers in Texas receive all Medicaid payments for providing services to Medicaid beneficiaries to which they are entitled,” it wrote, as reported by The Houston Chronicle.

 
 

Clipped from: https://www.reformaustin.org/healthcare/texas-feud-over-medicaid-is-costing-7-million-a-day/

 
 

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NV- State encourages school districts to pursue Medicaid repayments

[MM Curator Summary]: Many NV school districts are not taking advantage of Medicaid funds available for kids, and its not clear why.

 
 

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.

 
 

 
 

Carson City School District administration building.


Only eight of Nevada’s 17 counties are seeking Medicaid funding for student health services, and the state would like to help school districts do more to fully leverage funds available for reimbursement and assist with children’s increasing needs.In January this year, Carson City, Churchill County and Lyon County school districts were approved for Medicaid reimbursements in the amount of $2,018,299, $940,000 and $887,882, respectively, to be disbursed in quarterly amounts in fiscal year 2022-23.


Authorizations were made by the State Board of Examiners, which consists of Gov. Steve Sisolak, chairman, and members Attorney General Aaron Ford and Secretary of State Barbara Cegavske.


The school-based funding obtained for the School Health Services program includes medical screening, diagnostic and treatment services and is overseen by the Nevada’s Department of Health and Human Services. It is jointly funded by state and federal agencies to assist lower-income populations from children to seniors.
It underwent revisions in March 2020 when it was called the “School Based Child Health Services” program and had certain other language changed to allow state education agencies to provide medical services in schools.
“Way back, the federal government knew it doesn’t fund at the level for (Individual Education Plans), so I believe the intent was for districts to recoup some of the services we provide for our students,” according to Carson City School District’s Christine Lenox, director of student support services.
 

Medicaid was established in 1965 as a basic insurance program to help Americans gain access to affordable health care and has been tailored throughout the years. The goal in the educational setting has been to expand health amenities in schools where more medical screenings and diagnostic services can be offered in a convenient situation for families and students.

“Accessing health care can be a challenge for vulnerable populations,” said Nevada Medicaid Administrator Suzanne Bierman. “To meet that challenge, Nevada Medicaid is one of a number of states expanding Medicaid-funded services available in schools where it is convenient for students and families. Nevada Medicaid supports further adoption of the program by remaining school districts.”
 

The Centers for Medicare and Medicaid Services issued a letter in December 2014 that reversed its “free care” policy and allows schools to bill Nevada Medicaid for services recorded in an Individualized Education Program. The change impacted Nevada Medicaid’s ability to service students who were eligible without an IEP, which can act as a plan of care.

But according to Lenox, whether or not the reimbursements from these Medicaid programs come, the services will continue, no matter what.


“Whether we have this funding or not, we’re going to provide services,” Lenox said. “This would never dictate whether a service is provided or not.”


Medically necessary services listed in a student’s plan of care are intended to meet their health needs and reduce any physical or mental impairment. School districts providing services or evaluations through the Individual Education Plans, created under U.S. law for each public school to assist eligible children in need of special education, will tailor teams with parents and school staff members to help with the child’s specific learning disability or impairment.


In the school’s most basic team evaluating the child’s need, according to Lenox, team members include the general education teacher, special education teacher and parent. As a need and the IEP are assessed annually, others might be included on the team, such as a speech language pathologist, occupational therapist or a behaviorist. Members review the student’s progress and every three years, the team discusses eligibility for services.


“If the child has a deficiency in the area of language or expressive language, we need to program around that,” Lenox said. “We come up with this plan and then it’s implemented. Your speech pathologist would be working with this child in the manner your team’s decided on in a specific goal, and they log the work they’ve done and sign off with the time.”


For students who have more specialized needs – medical or nursing services, for example – the district will contract with third-party consultants or administrators such as implementation and operations firm Public Consulting Group, headquartered in Boston. The company specializes in education, health, human services and technology consulting, giving school districts online access to programs to track billing and compliance to relieve time constraints in some situations, Lenox said.


Carson City School District has been working with PCG for some time.
“Before I did this job, I did speech pathology, and I would see my students, put my notes (in the system), and it went straight up to the company who manages it,” Lenox said.


With approximately 1,110 students in Carson City now who are on an IEP, not every student receives every service, Lenox said. She’s also never had a parent turn down the services when asked.


“The child gets what they need, no matter what,” Lenox said. “It’s on the back side where we see the benefits. It doesn’t impact our general education fund as much. … Nothing would change for our students. We would still provide the work being done by the IEP team.”


In January, the Nevada Board of Examiners approved the reimbursements for the Carson City, Churchill and Lyon school districts that will be applied to their non-federal portion of school health services, medical screening and diagnostic services for children eligible for Nevada Medicaid or Check-Up programs.


For Lyon County School District, Superintendent Wayne Workman, whose executive cabinet includes Executive Director of Special Services Marva Cleven, Executive Director of Operations Harman Bains and grants manager Cindy Routh, the program has been beneficial to local students. Lyon County, as of 2020-21, had a total enrollment of about 8,817 as of 2020-21 and 1,218 students in its IEP program, according to nevadareportcard.nv.gov.


“We are extremely grateful for the increased flexibility that has been provided to school districts with Nevada Medicaid as we are now able to provide more services to students than ever before,” Workman said.
Lyon has participated in school-based Medicaid programs for a number of years, according to Cleven. The agreements enable schools to bill services for Applied Behavior Analysis for students with autism spectrum disorder, audiology, medical nutritional services, mental or behavioral health services, personal care, occupational therapy, physical therapy, physical and behavioral health screenings and speech therapy, she said.


“It’s important to note that services provided in the school setting do not impact the benefits of students outside of the school setting,” Cleven said. “They continue to have full benefits of their Medicaid programs.”
 

But why not all school districts have chosen to apply for the repayments is unknown, said Ky Plaskon, spokesman for the Nevada Medicaid program of the Nevada Department of Health and Human Services. The program was the third-largest source of federal funds for K-12 education in 2019, and even then, a survey from the American Association of School Administrators had found 84 percent of districts not seeking reimbursements for school-based health services were rural, according to Education Week.

“Some districts don’t know how easy it is,” Plaskon said.

As a Nevada district works with Medicaid through its process for participation, the contract is brought before the State Board of Examiners once every four years for approval.
School districts that would like to participate are invited to write to schoolhealthservices@dhcfp.nv.gov.

 
 

Clipped from: https://www.nevadaappeal.com/news/2022/mar/23/state-encourages-school-districts-pursue-medicaid-/

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Kansas lawmakers try to limit changes to state’s Medicaid program

[MM Curator Summary]: KS lawmakers are seeking to create a committee that would have to sign off on most Medicaid policy changes, big and small.

 
 

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.

 
 

 
 

Lawmakers are moving forward with a hotly contested provision to limit changes to the state’s Medicaid program for a year, a move its director has warned could debilitate the program’s ability to make even routine updates.

The proposal, which would also extend the contract of the three insurance companies that serve as managed care organizations for the KanCare program, initially came about as a separate bill.

Concern from lawmakers of both parties initially led to it being tabled in a House committee, but it later passed out and was subsequently added to the state budget. The House version of the budget bill was approved on a 73-49 vote Wednesday.

Rep. Kathy Wolfe Moore, D-Kansas City, Kan., the ranking Democrat on the House Appropriations Committee, called the item’s inclusion in the budget a “poison pill” and questioned its legality.

More:Kansas lawmakers advance parental bill of rights: ‘This is a bully’s bill of demands’

“Never before has the Legislature intervened and asked for a no-bid contract extension,” Wolfe-Moore said on the House floor Tuesday. “It has not happened. This smells bad, and I am certain if this goes forward, there will be some kind of investigation into this.”

If approved, the Kansas Department of Health and Environment, which manages KanCare, would have to appeal to a panel of top legislative leaders, called the Legislative Coordinating Council, to sign off on any changes to the Medicaid program.

There is a political dimension to the move as well.

If Attorney General Derek Schmidt, the presumptive Republican nominee for governor, defeats Gov. Laura Kelly in the November general election, it would fall to his administration to determine the framework for $4 billion in contracts to deliver Medicaid services.

Gov. Laura Kelly told reporters the idea was “absurd.”

“It’s political, you know,” she said. “They want to tie my hands around Medicaid entirely,”

More:Kansas lawmakers eye raft of proposed constitutional amendments. Here’s what it means.

Move would allow delay of Medicaid contract decision until after election

The Kelly administration was set to launch a request-for-proposal for the three MCO contracts in the fall ahead of a 2023 deadline to select the new vendors. Gov. Sam Brownback moved to privatize the state’s Medicaid program in 2013 and a new round of contractors were selected under his successor, Gov. Jeff Colyer, in 2018.

Rep. Brenda Landwehr, R-Wichita, chair of the House Health and Human Services Committee, defended the move as a way of ensuring the next governor, whomever they are, has adequate say in the nature of the KanCare program.

“How would you like to have to pick up on a negotiation that you didn’t start with in the first place?” she told reporters after a hearing on the matter last month. “That you didn’t ask for? That you didn’t want?”

But Schmidt is in the center of the debate in another sense as well.

Democrats requested last month an opinion for the attorney general’s office on the legality of extending the contracts, arguing it runs afoul of the state’s procurement process.

Schmidt spokesperson John Milburn said Feb. 22 that the matter was “under review” but didn’t address the potential conflict of interest involved.

Critics argue that, even if the move isn’t illegal, it would limit the state’s ability to punish contractors that didn’t adhere to their agreements with the state.

“If we truly had a bad actor, and we needed to threaten termination, that would be a meaningless threat really,” Sarah Fertig, KanCare’s executive director, told the House Health and Human Services Committee in February.

More:Kansas House approves legislative redistricting maps in rare show of bipartisan support

Top officials worry provision could limit Medicaid changes, big and small

In a rare move, no group or individual stepped forward to advocate for the bill in a February hearing and it is unclear who requested the provision’s inclusion in the budget.

Fertig has told legislators the structure could require her division to go before the LCC to obtain approval for even small changes.

But bigger moves would be impacted as well, she noted. Adding new drugs or treatment services would require approval, she said, as would changes to reimbursement rates and a move, desired by members of both parties, to expand post-partum coverage for mothers.

When a RSV outbreak occurred in eastern Kansas, Fertig added, it was necessary to quickly sign off on adding medications to help prevent or treat the virus among vulnerable individuals.

But Landwehr said stability would be a net positive for Medicaid enrollees.

“This is people’s lives,” she said. “And the less disruption that any cost to them the better off they will be.”

There is another consideration as well.

The federal COVID-19 emergency, which has provided for flexibilities in a number of different sectors, also gave states increased Medicaid funding in exchange for a number of temporary changes.

That includes not removing Medicaid participants from the rolls until after the public health emergency had ended, something that is expected later in 2022. This would mean ensuring legislators authorized to sign off on changes had the knowledge needed to address complications that might arise during the process of unwinding the COVID-19 order.

 

“We would have to bring them up to speed on these issues, coach them through it and then hope that they would vote to let us do what we need to do to manage the program,” Fertig said.

The provision has some distance to travel before becoming law. The budget will be subject to negotiations between the House and the Senate, who passed their own budget bill without the Medicaid provision last week.

Even if it advances, Kelly would have the option to use her line-item veto powers to remove it from the budget, even if she signs the larger spending blueprint.

But House Speaker Ron Ryckman, R-Olathe, defended the policy proposal when speaking with reporters in February, saying it mirrored the way legislators had imposed oversight over how the Kansas Department of Labor and other agencies handled the procurement process.

“We want to make sure that the system is intact and there’s not preferential treatment being used,” he said.

Andrew Bahl is a senior statehouse reporter for the Topeka Capital-Journal. He can be reached at abahl@gannett.com or by phone at 443-979-6100.

 
 

Clipped from: https://www.cjonline.com/story/news/state/2022/03/23/kansas-lawmakers-try-limit-changes-states-medicaid-program-kancare-gov-laura-kelly/7127911001/

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Kentucky House quickly advances bill putting tighter rules on food benefits, Medicaid

[MM Curator Summary]: KY legislators are trying again for more member responsibilities to be tied to Medicaid and SNAP benefits.

 
 

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.

 
 

 
 

KET Livestream

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GOP House Speaker Pro Tem David Meade on the House floor Thursday.

Republican lawmakers rushed a bill through the Kentucky House of Representatives Thursday adding work requirements for some Medicaid recipients and charging state officials with investigating food benefit use, among other proposed changes to public assistance. This was despite strong concerns and emotional pleas from Democrats and various advocacy groups that the bill would harm low-income Kentuckians who rely on assistance with food, healthcare and more.

House Bill 7, sponsored by Republican House Speaker David Osborne and Republican Speaker Pro Tempore David Meade, went through several changes during a House Health and Family Services Committee hearing, though in a way that some criticized as not being transparent to the public. After passing the committee, it was shortly after put up for the full House’s consideration. It then passed 71-26.

The bill would implement several new rules for public assistance including putting closer scrutiny on how food benefits – via the Supplemental Nutrition Assistance Program or SNAP – are used by low-income Kentuckians. It puts the Cabinet for Health and Family Services in charge of investigating cases of improper food benefit use and allows the Kentucky Attorney General to sue the cabinet if the proposed rules aren’t implemented. The bill would also permanently ban SNAP recipients from accessing all public assistance programs for repeated violations of selling an electronic benefits transfer card used for SNAP.

Rev. Kent Gilbert with the Kentucky Council of Churches was one of several who gave emotional testimony against the bill to the committee, in which no one spoke for the bill. He called for lawmakers to look “deep in [their] faith” to find ways to lift people out of poverty.

“We know for a fact that folks who are on SNAP benefits, for example, are primarily working folk, and they don’t always stay on SNAP if they can get two jobs,” Gilbert said. “If we pass this bill, you will create impediments to good care. It will take deserving Kentuckians’ food from their mouth, medicine from their cabinet and opportunities from the table.”

One Fayette County resident who testified before the committee criticized how Republicans on the committee made changes to the bill by replacing it with a changed substitute, with the text of the substitute only available online to the public after the committee had passed it. The committee also approved an amendment to the bill – the text also only made available to the public afterward – that removed a part of the original bill seen as problematic by advocacy groups.

The amendment removed the provision that would have eliminated what’s known as “broad-based categorical eligibility” (BBCE) which allows cabinet officials to qualify Kentuckians for SNAP benefits automatically if they qualify for other forms of public assistance, such as Temporary Assistance for Needy Families. One research group in the state had raised concerns that eliminating BBCE would impact school districts’ ability to give out free meals to students.

Cabinet for Health and Family Services Secretary Eric Friedlander also told the committee about the significant increase in staffing the cabinet would need to implement the new regulations, having to invest tens of millions of dollars and hire hundreds of more employees in part to simply answer phone calls from Kentuckians regarding public assistance.

“There could be a significant backlog on phone lines,” Friedlander said. “We already have 20-minute waits. If this doubled that number, I just think we’d have the potential for a real disaster situation.”

House Bill 7 would also create work requirements for some Medicaid recipients, requiring at least 80 hours of “community engagement activities” a month to stay enrolled. Once the bill moved on the House floor, Meade defended the bill by saying the committee substitute made improvements to the legislation by adding age restrictions and exempting those physically and mentally unable from the Medicaid work program. A federal judge in 2019 struck down former Republican Gov. Matt Bevin’s changes to the state’s Medicaid program that also included “community engagement” requirements.

“A lot of fear-mongering going on,” Meade said. “The only way you lose your benefits is that you either violate the law, or you are an able-bodied adult with no dependents that does not participate in the [community engagement] program.”

Democratic Rep. Angie Hatton was one of several in the minority who gave emotional commentary, questioning the need for provisions that go after instances of SNAP benefits fraud. She also expressed concerns that the body was considering the legislation without a fiscal impact statement or an updated corrections impact statement for lawmakers to see.

“There is no evidence to suggest that we ought to be hunting for gnats with a sledgehammer in this way,” Hatton said. “When we are going to take measures like this, we at least owe it to those people to do it properly: to wait till we have a fiscal impact statement, to allow people to come and testify to the appropriate version of the bill. This is food and medicine, guys.”

Before the bill passed, Republican Rep. Josh Bray – who proposed the committee amendment that removed the provision eliminating BBCE – spoke in favor of the measure, saying the amendment made it a “better bill.”

“It’s important that we give people the safety net that they need so that when things go wrong, they’ve got something to fall back on,” Bray said. “But it’s also important that we give people a hand up and not a handout.”

Clipped from: https://www.wkyufm.org/2022-03-18/kentucky-house-quickly-advances-bill-putting-tighter-rules-on-food-benefits-medicaid

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DHHS cautions of state Medicaid funding shortfall for 2021-22; COVID-19 expenses biggest impact

[MM Curator Summary]: NC officials are warning about new monies needed to fund Medicaid spending increases, which are driven by enrollment surges and actions in response to the pandemic.

 
 

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.

 
 

Another expected, but telling, ripple effect from the COVID-19 pandemic is that North Carolina’s Medicaid program is headed to a budget shortfall for 2021-22.

Kody Kinsley, the state’s health secretary, offered that projection last week to the joint legislative oversight Health and Human Services committee.

If that occurs, it would be the first non-surplus in eight fiscal years.

Medicaid currently covers 2.7 million North Carolinians with a $20.14 billion budget for 2021-22.

That represents about a 480,000 enrollment increase since the beginning of the pandemic in March 2020.

Enrollment also is up 32% from 1.84 million at the start of the 2013-14 fiscal year.

There have been Democratic-led efforts since 2014 to expand Medicaid coverage to another 450,000 and 650,000 through the federal Affordable Care Act, also known as Obamacare.

Healthinsurance.org estimates about 621,000 North Carolinians would benefit from expansion, with 212,000 of those individuals being listed as having no other realistic option for health coverage.

The nonprofit group also estimates that North Carolina is losing out on $5.9 billion in federal Medicaid funds that could gained through expansion.

Reasons for shortfall

Kinsley cited several factors for the potential shortfall, including: actual enrollment over the past nine months exceeding projections; temporary rate increases in response to the pandemic “continuing longer than planned;” additional expenses to resolve staffing shortages in skilled nursing facilities; and changes in state hospital assessment fees.

Through January, the state Medicaid program has spent 59% of its 2021-22 budget, or $11.95 billion out of $20.14 billion.

At the same time period in 2020-21, the program had spent 51%, or $9.18 billion of $18.2 billion.

Kinsley said the N.C. Department of Health and Human Services “is actively pursuing FEMA reimbursements for eligible COVID-related costs to maximize and extend support for services across North Carolina.”

For the 2009-10 through 2013-14 fiscal years, the state Medicaid program had nearly a $2.4 billion financing gap that had to be filled through additional legislative funding.

At that time, the state Medicaid program had a $14 billion budget.

The budget overrun and additional funding requirement was a key issue during the 2012 governor’s race won by Republican Pat McCrory.

The McCrory administration credited improved budgeting forecasts and more conservative spending for beginning what became eight years of Medicaid funding surpluses that has continued through the first five years of the Cooper administration.

Although Kinsley said he couldn’t project when a budget surplus would resume, he told legislators it is likely to resume in a post-pandemic period.

Kinsley said the Medicaid program’s budget priorities for 2022-23 will include:

n Expanding access to treatment and services for those most at need, including those involved in the justice system and child welfare system.

n Assisting individuals gain access “to the right level of high-quality services for their needs, including care in their community;”

n Combating the increase in behavioral health crises, including overdoses and youth suicides, with expanded crisis supports and investing in prevention and resilience initiatives;

n Increasing access to child and family well-being services;

n Sustainable pay for early childhood care workers; and

n Building “a more robust” local public-health infrastructure that “can be prepared for the next crisis.

 
 

Clipped from: https://journalnow.com/news/state-and-regional/govt-and-politics/dhhs-cautions-of-state-medicaid-funding-shortfall-for-2021-22-covid-19-expenses-biggest-impact/article_3e6f0b1e-a6da-11ec-88b3-db7bd094fbd6.html

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Idaho House passes 6.6% increase for 2023 Medicaid budget

[MM Curator Summary]: Idaho Medicaid spending has grown 100% in 10 years. The current budget requires $840M of state funds.

 
 

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.

 
 

Legislators have to finish setting the state budget to adjourn 

 
 

Legislators work from the House chamber at the Idaho Capitol on Jan. 17, 2022. (Otto Kitsinger for Idaho Capital Sun)

The Idaho House of Representatives passed the state’s largest budget of the year Tuesday, the Idaho Department of Health and Welfare’s 2023 Medicaid budget.

The budget includes a total of $4 billion in funding from all sources, which is a 6.6% increase from the current budget. About 70% of the money comes from federal funds, which total almost $2.8 billion. The budget includes $830 million in state general fund money. The rest comes from dedicated funding sources, such as the Millennium Fund, which was created with money from settlements from tobacco lawsuits. 

Medicaid is a state and federal program that provides free or low-cost health care to low income individuals and children who meet eligibility criteria. 

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The budget, which is funded through House Bill 777, pays for 213 full time positions and provides $1.25 per hour per employee for merit-based pay increases. 

Rep. Paul Amador, the Coeur d’Alene Republican who sponsored the budget bill, said it is necessary to pay the state’s bills. 

“You will probably hear some debate about the unsustainability of Medicaid funding in Idaho, and I will not disagree with that,” Amador said during floor debate Tuesday. “This budget has ballooned over the last several years. But we are bound by our policies that are adopted in state statute at this time so we have to pay our bills, and this is essentially paying our bills for Medicaid for the next coming year.”

Some far-right conservatives in the House tried to kill the budget, pointing out its status as the state’s largest budget and calling it a windfall for the Idaho Department of Health and Welfare. 

“It is unsustainable at the rate we are going,” said Rep. Heather Scott, R-Blanchard. “I think we need to send a message by voting this bill down, resending it back and having it reworked.”

Rep. Ron Nate, R-Rexburg, said total funding for the Medicaid budget was just under $2 billion when he came to the Idaho Legislature in 2015. 

“The spending is clearly uncontainable. It has doubled in less than a decade,” Nate said during floor debate. “And let’s not forget that Medicaid is not sustainable without federal dollars. The federal government is on a path to financial ruin right now. What happens if the federal government can’t pay its bills?”

Since 2015, Idaho has been one of the fastest-growing states in the country, and Idaho voters voted to expand Medicaid eligibility in 2018. Medicaid expansion extended eligibility to about 100,000 additional low-income Idahoans under age 65.

Idaho began the legislative session with a projected state budget surplus of $1.9 billion.

Despite opposition by several conservatives, the Idaho House passed the budget bill by a vote of 43-27. The bill heads next to the Idaho Senate for consideration, where it will likely be taken up quickly. Legislative leaders are working to adjourn the 2022 session for the year on Friday.

Amador referenced how the Medicaid budget’s survival and passage is intertwined with the Legislature’s ability to adjourn, saying the state has to follow its laws and policies and pay the program’s bills.

“I appreciate your green light (of support); I’d like to go home this week,” Amador told legislators just before they voted Tuesday.

 
 

Clipped from: https://idahocapitalsun.com/2022/03/22/idaho-house-passes-6-6-increase-for-2023-medicaid-budget/

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TennCare is preparing to expand dental benefits, but only 1 in 3 dentists accepts reduced payments

[MM Curator Summary]: The Governor is putting up more money, but 70% of TN dentists won’t take Medicaid as payment because of low rates and higher no-show appointments.

 
 

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.

 
 

 
 

More dentists will have to start participating in the state’s Medicaid program if every adult is going to get new oral health coverage. That’s the conclusion of TennCare advocates who found that fewer than one in three dentists in Tennessee accept the lower rates paid by Medicaid.

Gov. Bill Lee has put the money in his budget to expand dental benefits to everybody on TennCare. It also includes money to help incentivize dentists to open offices in underserved communities. But that doesn’t necessarily fix the problem of so few dentists taking Medicaid patients.

“There’s not enough to even see the children who have been able to go with their Medicaid insurance and get dental benefits,” says Kinika Young, senior policy director of the Tennessee Justice Center. “So we need more providers to step up.”

A TJC policy brief published in January finds that 30% of Tennessee dentists take Medicaid. And only about half of the children on Medicaid in Tennessee went to see a dentist in 2019.

A common complaint among dentists is that low-income patients are more likely to miss appointments. But Young says that’s why dentists need to learn how to better serve them, like offering extended hours and flexible scheduling.

Dentists have said the state’s Medicaid program, known as TennCare, must raise its rates. And Young agrees. According to a national analysis by Milliman consulting firm, the rates are usually less than half of what private insurance pays.

 
 

Clipped from: https://wpln.org/post/tenncare-is-preparing-to-expand-dental-benefits-but-only-1-in-3-dentists-accepts-reduced-payments/