Tag: State News

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OR- Oregon lawmakers consider bill to head off Medicaid disenrollments

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[MM Curator Summary]: The state is planning for the task of determining whether the 300k+ members added to the rolls during the pandemic are still eligible.

 
 

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.

 
 

 
 

Aaron Kunkler | Feb 15, 2022 | Oregon

Lawmakers in the Oregon legislature are examining ways to head off a massive Medicaid disenrollment once the COVID public health emergency is lifted.

One bill attempting to do this, HB 4035, would require the Oregon Health Authority and the Department of Human Services to develop a process for conducting medical assistance program redeterminations following the end of the public health emergency declared on March 8, 2020.

 
 

The federal Family First coronavirus Recovery Act mandated that people who were enrolled in Medicaid during the public health emergency could not be disenrolled until the emergency order was lifted. After the lifting of the order, states will have a year to redetermine eligibility of their Medicaid enrollees.

According to the Oregon Health Authority, at the end of January 2022, there were more than 1.38 million members enrolled in the Oregon Health Plan, the state’s Medicaid program. It’s an increase of roughly 302,000 members since March 2020 when the emergency was declared. Federal law generally requires people on Medicaid to have their eligibility redetermined annually.

The Oregon Health Authority estimates that nearly all of the 302,000 enrollees will lose Medicaid coverage after the public health emergency is lifted. Health authorities in Washington are struggling with similar questions.

HB 4035 would do a number of things, including submitting a report to the legislature by the end of this May on their progress. It also requires the health authority to maintain continuous enrollment for the medical assistance program, and give the state some flexibility until the end of 2023 to maintain coverage for Oregonians and minimize the risk of disruptions in coverage or care for high-risk populations or people at risk of becoming uninsured.

It also allows temporary limit waivers on disclosure of enrollee information to promote greater information sharing and community partners assisting individuals who are reapplying for or seeking to maintain eligibility in the medical assistance program who are moving from Medicaid to plans under the health insurance exchange.

It also creates a task force to develop a bridge program to provide affordable health insurance coverage and improve coverage for people who regularly enroll and disenroll.

The bill was approved by the House Committee on Health Care with a do pass recommendation on Feb. 14 and referred to Rules. It cleared on a 9 – 1 vote, with Rep. Raquel Moore-Green casting the sole vote against it.

Clipped from: https://stateofreform.com/news/oregon/2022/02/oregon-lawmakers-consider-bill-to-head-off-medicaid-disenrollments/

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KS- Long-promised Medicaid Expansion bill introduced in Kansas legislature

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[MM Curator Summary]: The KS governor facing re-election is making the normal expansion promises: “free” federal money, jobs and saving rural hospitals.

 
 

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.

 
 

FILE – The Kansas Statehouse stands against the sky as the sun sets in the distance Monday, April 27, 2020, in Topeka, Kan.(Charlie Riedel | AP)

TOPEKA, Kan. (WIBW) – Governor Laura Kelly is hoping to make good on her 2018 campaign promise to expand Medicaid with new legislation introduced on Wednesday.

Kansas Governor Laura Kelly says on Wednesday, Feb. 9, she announced legislation to expand Medicaid – KanCare – to provide over 150,000 Kansans with access to affordable healthcare.

Gov. Kelly said the move would also create over 23,000 new jobs to strengthen the state’s economy.

“Expanding Medicaid so that thousands of hard-working Kansans have access to affordable health care would boost the Kansas economy,” Kelly said. “Expansion would inject billions of dollars into our state, create thousands of jobs, help retain our healthcare workers in Kansas —and help rural hospitals’ bottom lines. It’s time to work together to deliver for Kansans and get this done once and for all.”

Under the proposed bill, Medicaid would expand to cover Kansans who earn up to the full 138% of the Federal Poverty Level starting on Jan. 1, 2023.

Gov. Kelly said about 90% of the expansion would be paid by the federal government.

Furthermore, Kelly said if Medicaid is expanded, Kansas is poised to get an additional $370 million over the next eight fiscal quarters for the current enrollees. She said that is a total of $68.5 million in State General Fund savings in the Fiscal Year 2023 alone, which will be reallocated for a one-time investment in housing, childcare and workforce development.

A 2022 statewide survey found 78% of Kansans support Medicaid expansion to allow for more residents to qualify for coverage.

“The list of reasons to expand Medicaid grows with every year we refuse to do so,” said Senate Democratic Leader Dinah Sykes. “This wildly popular policy will ensure we have a healthy workforce, create jobs, and attract businesses. More importantly, it will allow our fellow Kansans to flourish and participate fully in our state, which brings prosperity for all of us. The first best time to expand Medicaid was in 2014. The next best time is now.”

Kelly said this is not only the right thing to do for Kansas, but it is incredibly popular among all political parties.

“Expanding Medicaid is enormously popular among Kansas and addresses many issues facing the state. First and foremost, it is a pro-business, pro-growth policy,” said House Democratic Leader Tom Sawyer. “Throughout the legislative session, people repeatedly ask what we can do to keep our college graduates in the state and bring in outside business investment. Medicaid expansion is a clear solution with bipartisan voter support. It’s past time to embrace this common-sense policy.”

According to the Governor, expanding Medicaid in the Sunflower State would boost the economy by:

  • Providing affordable health insurance to hundreds of thousands of Kansans
  • Stimulate the economy for rural, suburban, and urban communities alike
  • Create tens of thousands of new jobs
  • Inject billions of dollars in increased economic output
  • Retain health care jobs in Kansas

The bill would require the Secretary of Health and Environment to gather data from applicants about employment history through the Medicaid application. Unemployed or underemployed Kansans will be referred to the Department of Commerce or Department of Children and Family Services to help the applicant find job opportunities.

In 2021, a Medicaid expansion amendment to SB 238, which died on general orders on May 21. A day before the bill died, Gov. Kelly vetoed SB 29 which would have provided short-term health plans because a solution to the problem fixed by the bill would have been to expand Medicaid instead.

In September she sent a letter to Congressional leadership to again urge them to pass Medicaid expansion legislation.

In January, House Democrats said they introduced a Medicaid expansion amendment to the Kansas Constitution, as well as one to legalize marijuana recreationally and medicinally. In February 2021, Kelly even proposed Medicad expansion be funded by the legalization of marijuana.

Medicaid expansion was a promise Kelly ran on in her campaign for Governor in 2018.

Clipped from: https://www.kwch.com/2022/02/10/long-promised-medicaid-expansion-bill-introduced-kansas-legislature/

 
 

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SD – Senate rejects Medicaid expansion, leaving it to election

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[MM Curator Summary]: State reps voted naye on expansion by a 2 to 1 margin.

 
 

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.

 
 

PIERRE, S.D. (AP) — A proposal to expand Medicaid health coverage eligibility was defeated in the South Dakota Senate Tuesday, leaving the decision to voters in the November election.

Republican Sen. Wayne Steinhauer had brought a proposal to the Legislature to make Medicaid, a federal-state health insurance program for low-income people, available to people who live below 133% of the federal poverty level. That is currently about $17,000 annually for an individual or $35,000 for a family of four.

“This thing is about people,” he said in an effort to counter arguments from his fellow Republicans that it would grow the size of government and drain money from elementary and high schools.

The Republican-controlled Senate rejected his bill on a 12 to 23 vote.

But a campaign backed by South Dakota’s major health care systems is trying to get voters to pass a constitutional amendment to expand Medicaid eligibility on the November ballot.

“It’s clear that the only path to expanding Medicaid in South Dakota is by letting the people vote on it directly,” said Zach Marcus, the manager for the campaign, in a statement.

He asserted that the proposal would allow 42,500 more people to access health care coverage and bring $1.3 billion in federal money to the state.

 
 

Clipped from: https://www.westport-news.com/news/article/SD-Senate-rejects-Medicaid-expansion-leaving-it-16921734.php

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NC- Key NC Republican lawmakers weighing Medicaid expansion vote before November

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[MM Curator Summary]: The committee looking at expansion will not release its report until after the legislative session, but will release it before the gubernatorial election.

 
 

 
 

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.

 
 

 
 

By Travis Fain, WRAL statehouse reporter

Key Republican leaders on Tuesday said to watch for an up-or-down vote on a potential Medicaid expansion deal before the November elections.

That doesn’t mean North Carolina, one of 12 U.S. states that hasn’t expanded Medicaid, will take the leap more than a decade after federal funding became available for the expanded health insurance program. But the prospects may be better than ever after years during which the proposal was a nonstarter in the Republican-controlled General Assembly.

Medicaid expansion would add hundreds of thousands of people, many of them the working poor, to the taxpayer-funded health insurance program that currently serves roughly 2 million people in North Carolina, most of them children, pregnant women, seniors citizens and people with disabilities.

Democrats have advocated for the expansion in an effort to close a health insurance coverage gap. Republicans, however, have long expressed concerns about how much it would cost taxpayers.

A joint House-Senate committee studying the issue is scheduled to hold its first meeting Friday. The committee may submit an expansion plan to the full General Assembly later this year.

“It depends what the substance of the measure is, but I think there’s a pathway,” Senate leader

Phil Berger
said Tuesday, adding that any vote would likely come before the November elections.

State Rep. Donny Lambeth , the committee’s co-chair and a long-time proponent for some sort of expansion plan, said Tuesday that one of the first things the committee will do is ask to push back its timetable.

The state budget, which created the committee, called on the group to present its findings before the 2022 legislative session begins. Lambeth, R-Forsyth, said it probably will take “into the summer and fall” for the group to complete its work.

Lambeth also said he’d like whatever the committee comes up with to come before the full General Assembly before the November elections, with implementation of any expansion approved in January.

“I think it’s possible for January,” Lambeth said. “That’s my goal.”

Democrats, including Gov. Roy Cooper, have pushed expansion for years, and at times there has been Republican support at the statehouse. Lambeth helped lead an effort in the North Carolina House to pass a compromise version that would have included work requirements for recipients. The plan didn’t have enough support in the state Senate, though, and it fell apart after the courts struck down work requirements.

Last year Senate Republicans seemed to be on board, but there wasn’t enough support in the House. A new enticement from the federal government—an extra $1.7 billion or more from the federal government for states that expand now—has helped boost support.

What a successful proposal would look like this year remains to be seen. Neal Inman, the chief of staff for Speaker of the House Tim Moore , said last week that there are “no predetermined outcomes” for the study committee, and any plan would have to overcome Republican concerns that it would put too many people on government health insurance.

Sen. Jim Burgin , R-Harnett, noted during a separate health committee meeting Tuesday that adding several hundred thousand people to the state’s Medicaid rolls would mean a third of the state’s population relies on Medicaid.

“Is a third of our population on Medicaid going to be sustainable in the long term?” he said.

Clipped from: https://www.wral.com/key-nc-republican-lawmakers-weighing-medicaid-expansion-vote-before-november/20140451/

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LA- Humana Selected by Louisiana Health Department to Serve Medicaid Beneficiaries

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[MM Curator Summary]: Humana is one of the MCO winners in LA.

 
 

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.

 
 

Kentucky-based company will help people across the Bayou State achieve their best health

BATON ROUGE, La., February 14, 2022–(BUSINESS WIRE)–Leading health insurer and health care services company Humana Inc. (NYSE: HUM) has been notified by the Louisiana Department of Health (LDH) that the LDH intends to award a contract to Humana to deliver health care coverage to Medicaid beneficiaries across the state. Humana’s Medicaid division — Humana Healthy Horizons — expects to begin administering the coverage in Louisiana later this year, pending the state’s completion of its standard protest period.

Humana will serve adults and children across Louisiana with the goal of helping them improve their health and well-being through a whole-person, value-based approach that goes beyond traditional clinical care.

– ADVERTISEMENT –

“We are deeply committed to increasing access to care and improving health outcomes of Louisianans who have faced numerous public health crises, natural disasters, and other challenges over the course of the pandemic,” said Humana Medicaid President John Barger. “It is an honor and privilege to be chosen by The Louisiana Department of Health to serve people across Louisiana. We will provide those covered by Medicaid holistic care that prioritizes both their physical and mental well-being. And we are excited to bring our data-enabled population health model along with Humana’s rich history of innovation to the Louisiana Medicaid program.”

Humana is one of five health plans selected as part of a statewide Medicaid managed care procurement issued last year. The state contract will offer an initial three-year term of service and take effect later this year, with the option of renewal terms thereafter. The statewide program – administered by the five plans – will provide health care to approximately 1.6 Million Medicaid enrollees.

“This selection reinforces Humana’s decades-long commitment to not only delivering quality health care to Louisianans but also to playing a vital role in improving the health of the communities we serve,” said Tony Mollica, Humana Medicaid Regional President. “We take pride in the work we do here in Louisiana. Our team thoughtfully designed a health strategy – rooted in Humana’s unique approach to population health – to meet the specific urgent and long-term needs of Louisianans, which has been a rewarding experience. I’ve witnessed first-hand how Humana forms invaluable and lasting partnerships with local residents, health care providers and community organizations.”

Humana currently serves a total of approximately 450,000 Louisianans through Humana Medicare Advantage plans, Medicare prescription drug plans, commercial group health plans, and the TRICARE military health care program as administered by Humana. Humana’s participation in Louisiana’s new Medicaid program – pending the state’s completion of its protest period – will allow the company to bring its services to more Louisianans across the state.

Humana is working to address social determinants of health in the state — like lack of transportation and food insecurity — through its Bold Goal program. The Bold Goal is Humana’s population health strategy to improve the health of the communities it serves. New Orleans and Baton Rouge are among Humana’s official Bold Goal communities.

In addition, during the pandemic, Humana partnered with local organizations, like Healthy BR and Makin Groceries Mobile, who are facing unprecedented demand from Louisianans in need of critical services. The Humana Foundation, which is the philanthropic arm of Humana, donated $200,000 to the recovery and relocation efforts for those impacted by Hurricane Ida in Louisiana.

About Humana Healthy Horizons

In 2020, Humana launched its new Medicaid brand, Humana Healthy Horizons™. With this new brand, we are committed to continue demonstrating our strong ability to manage complex populations and create solutions that lead to a better quality of life for our members. Nationally, we serve Medicaid enrollees through Medicaid Managed Care (MMC), Managed Long Term Services and Supports (MLTSS) programs, Centers for Medicare and Medicaid Services (CMS) Financial Alignment Initiative Dual Demonstrations, MA, D-SNPs, and PDPs.

Humana has served Medicaid populations continuously for more than two decades and currently manages Medicaid benefits for more than 930,000 members nationally. We have developed expertise providing care management, care planning, and specialized clinical management for the complex needs of Temporary Assistance for Needy Families (TANF); Children’s Health Insurance Program (CHIP); Medicaid Expansion; aged, blind, or disabled (ABD); and dual eligible populations within a social supports‐based framework. Through these years of experience, we have also developed significant expertise in integrating physical health, behavioral health, pharmacy, and social services and supports for a whole-person centered approach to improve the health and well‐being of our members and the communities we serve.

Humana Healthy Horizons is a Medicaid Product of Humana Health Plan, Inc.

About Humana

Humana Inc. (NYSE: HUM) is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.

To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience that makes health care easier to navigate and more effective.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:

  • Annual reports to stockholders
  • Securities and Exchange Commission filings
  • Most recent investor conference presentations
  • Quarterly earnings news releases and conference calls
  • Calendar of events
  • Corporate Governance information

View source version on businesswire.com: https://www.businesswire.com/news/home/20220214005840/en/

Contacts

Jim Turner
Humana Corporate Communications
jturner2@humana.com
502.608.2897

Clipped from: https://finance.yahoo.com/news/humana-selected-louisiana-health-department-213000762.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAEJk5Qw5z_OGBgARZtjaPsPdinvY3M44iBh-AJECeTvm7EzeZ3jL7GafCq52TnzA8H5gWf2MO8L8rWHVB6ikPD9HpsSOLWouRDOfC5aKBLMOeOV99JiIAQCtb3kJ-wqT0WzDpzc2MW5hBQuS4aoWjDASTBSsiBiGq1QOqs8Y3ROu

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FL- Governor, lawmakers differ on Medicaid ‘critical care’ funding – South Florida Business Journal

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[MM Curator Summary]: Hospitals are crying foul, but legislators say hospitals are crying wolf because the hospitals just got $100M in the direct payments program for Medicaid.

 
 

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.

Health care funding

krisanapong detraphiphat

As state legislators head into budget negotiations, both chambers have agreed to eliminate additional “critical care” funding for hospitals that treat the most Medicaid patients. Those dollars are used to give automatic rate enhancements to those hospitals. And Gov. Ron DeSantis, in his budget recommendations, included recurring funding for the hospitals.

But House budget writers didn’t just eliminate the so-called critical care fund. The House recommended removing an additional $100 million in state money (which is matched with federal Medicaid funds) currently used to reimburse hospitals and steer the money instead to help train future nurses. All told, it’s a nearly $252 million reduction to hospital inpatient and outpatient reimbursement rates and a $100 million bump to higher education.

House leaders defend the move because hospitals are getting money from a new supplemental Medicaid financing program called Direct Provider Payment or DPP. DPP is allowable under a federal waiver and lets hospitals use funds to bridge the difference between Medicaid reimbursements and their costs of providing the care. Florida does not contribute any state dollars to the DPP program. Instead, it is funded with local tax dollars generated by hospitals.

“They are contorting themselves because they believe they never should be cut,” said House Speaker Chris Sprowls, who pointed out that hospitals had their “second-best year” last year because of the enhanced funding they received. “They have a significant influx of money … and all we hear is ‘oh the sky is falling.'”

Sprowls also said it’s time to act because the state has a “significant nursing shortage,” and hospitals should have “skin in the game” to solve the problem.

Florida Hospital Association President and CEO Mary Mayhew, whose association commissioned the report that identifies the current and looming shortfall, said the goal to increase education funding is laudable. Hospitals currently partner with colleges and universities to train staff, she said. But, she noted, increasing education funding “really shouldn’t be supported at the state level through a cut to hospitals.”

Mayhew also said she is worried about the state’s commitment to helping fund the Medicaid program. Medicaid is administered and funded jointly by the state and federal governments. Mayhew said removing $100 million in general revenue is troubling.

She said just 4% of the general revenue in the current state fiscal year budget was spent on hospital funds.

“We are not driving general revenue (commitments),” she said, adding, “What is the problem we are trying to fix with all the money? There’s no hole; there is no general revenue hole in the state budget,” Mayhew said. “I recognize they are looking over the entire state budget, but I have to raise awareness around the consequences of cuts to hospitals and the care they provide to Medicaid patients.”

 
 

Clipped from: https://www.bizjournals.com/southflorida/news/2022/02/15/medicaid-funding-differ.html

 
 

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FL- Hospital to pay $5.5M to settle improper Medicaid payments case

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[MM Curator Summary]: A Florida hospital was “donating” services, but then getting federal matching dollars for them, in violation of federal law.

 
 

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.

 
 

NAPLES — NCH Healthcare System, which operates two Collier County hospitals, has agreed to pay the federal government $5.5 million to settle allegations it made donations to local units of government to improperly fund the state’s share of Medicaid payments to NCH.

The claims resolved by the settlement are allegations only and there has been no determination or admission of liability, according to hospital officials and a statement from the U.S. Department of Justice. The case, the DOJ release states, settles “common law allegations for impermissible Medicaid donations.”

In an email response on the case from the Business Observer, a spokesperson with NCH — a nonprofit that cares for more than 40,500 patients in its two hospitals, NCH Baker Hospital Downtown and NCH North Naples Hospital, with a combined 716 beds and some 700 physicians — says the hospital system “fully cooperated with the DOJ.”

“There were other hospitals in Florida similarly situated,” added Shawn McConnell, director of marketing and communications at NCH, in the -mail. “This situation dates back to 2014 and 2015, long before the current administration arrived. This settlement is due to a difference of interpretation of the rules. NCH decided to settle instead of going to court, to avoid spending more time and money.”

Authorities contend that, between October 2014 and September 2015, “NCH made improper, non-bona fide donations by: (1) providing free nursing and athletic training services to the Collier County School Board; and (2) assuming and paying certain of Collier County’s financial obligations,” the release states.

Both types of donations, officials allege, were designed to increase Medicaid payments received by NCH, without any actual expenditure of state or local funds. “In particular, NCH’s donations freed up funds for the county and school board to make payments to the state as the state share of Medicaid payments to NCH,” the release states. This state share was “matched” by the federal government before being returned to NCH as Medicaid payments.

“The Medicaid payments NCH received were thus funded by the federal government and NCH’s own donations, in violation of the prohibition on non-bona fide donations,” the release states.

The Florida Medicaid program provides medical assistance to low-income individuals and individuals with disabilities, and is jointly funded by the federal and state governments. Under federal law, Florida’s share of Medicaid payments must consist of state or local government funds, and not “non-bona fide donations” from private health care providers, such as hospitals. A non-bona fide donation is a payment — in cash or in kind — from a private provider to a governmental entity that is then returned to the private provider as the state share of Medicaid.

The private provider’s donation triggers a corresponding federal expenditure for the federal share of Medicaid, government officials say, which is also paid to the private provider. “This unlawful conduct causes federal expenditures to increase without any corresponding increase in state expenditures, since the state share of the Medicaid payments to the provider comes from and is returned to the provider,” the release states.

The prohibition of this practice, officials say, ensures that states are in fact paying a share of Medicaid payments and thus have an incentive to curb Medicaid costs and prevent unnecessary services.

“States and local units of government must use their own money when seeking federal Medicaid matching funds to help ensure that Medicaid payments are determined by beneficiaries’ medical needs rather than donations by hospitals or other health care providers,” Acting Assistant Attorney General Brian Boynton of the Justice Department’s Civil Division says in the release. “When private parties violate the rules by making improper donations to fund the state share of Medicaid, they endanger the integrity of the Medicaid program.”

“Millions of Floridians depend on the Medicaid Program for medical care and related services,” adds U.S. Attorney Roger Handberg for the Middle District of Florida, in Tampa, in the release. “This settlement underscores our commitment to protecting the integrity of the Medicaid program by ensuring that government funds are legally obtained and used for their intended purposes.” 

The resolution of the case was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section and the U.S. Attorney’s Office for the Middle District of Florida, with assistance from the U.S. Department of Health and Human Services Office of Inspector General.

 
 

Clipped from: https://www.businessobserverfl.com/article/hospital-to-pay-5-5m-to-settle-improper-medicaid-payments-case

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IA- House scales back proposed changes to Medicaid, food stamp eligibility

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[MM Curator Summary]: There are actually several new eligibility-confirming steps required in the new version of the bill this year, including enforcement of routine eligibility checks and cooperation with child support.

 
 

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 steps of the Iowa Capitol. (Photo by Katie Akin/Iowa Capital Dispatch)

Iowans would face new requirements when applying for programs like Medicaid or food stamps under a bill advancing in the Iowa House.

The proposal was born of a 2021 Senate bill that would have required additional identity verification and asset testing for public assistance applicants. House lawmakers did not take up the bill last session.

Upon returning to the Capitol in 2022, the House split the Senate bill into several parts, holding separate subcommittees on each component. Lawmakers combined some of the proposals into House Study Bill 698, a single bill to address the integrity of Iowa’s public assistance programs.

“We have done a lot of work on this bill to make sure that we are providing a safety net that Iowans need, but we also want to protect the taxpayer dollars,” said Rep. Ann Meyer, chair of the House Human Services Committee and a leader on the package.

The new proposal, which advanced Tuesday through the House Human Resources Committee, would make several changes to Iowa’s public assistance program:

  • Applicants would be required to complete a computerized, knowledge-based questionnaire to confirm their identity before receiving public assistance from the state.
  • The Department of Human Services (DHS) must routinely check whether recipients of public assistance are still eligible for the Supplemental Nutrition Assistance Program (SNAP) or Medicaid. 
  • Applicants for SNAP would be required to cooperate with child support in order to qualify for the program.

The Iowa Department of Human Services is tasked with implementing the changes – as permitted by federal law – by 2024, under an amended version of the proposal. 

Some of the more controversial provisions from the original Senate proposal, such as asset testing for food stamps, are not part of the current House bill. But Democrats still raised concerns that the changes could create new burdens on families.

“I’m just concerned that, at a time when grocery costs are skyrocketing and we know that SNAP recipients are already having their benefits reduced, I just want to move forward with ultimate caution,” said Rep. Kristin Sunde, D-West Des Moines. “… I don’t want kids to be impacted adversely.”

The Human Services Committee voted 13-8 to approve the bill, marking it eligible for floor debate and clearing a Friday legislative deadline.

 
 

Clipped from: https://iowacapitaldispatch.com/2022/02/15/house-scales-back-proposed-changes-to-medicaid-food-stamp-eligibility/

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KS- House bill delays rebidding state’s $3.9 billion Medicaid contracts until after governor’s race

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[MM Curator Summary]: Legislators want to give the next governor a say in the MCO contract renewals.

 
 

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.

 
 

Skeptics worry about no-bid contract extensions, reform delays and federal scrutiny

 
 

Rep. Brenda Landwehr, R-Wichita, said the Kansas Legislature should approve a bill blocking until after the 2022 election for governor the rebidding of Medicaid contracts with managed care organizations serving about 400,000 people enrolled in KanCare. (Thad Allton for Kansas Reflector)

TOPEKA — A bipartisan cluster of House members, three Kelly administration agencies and a core group of advocates for the 440,000 Kansans in Medicaid shared unease with legislation blocking the rebidding of KanCare contracts with managed-care companies until after the governor’s race in November.

Officials working for Democratic Gov. Laura Kelly have been preparing to launch in October a competitive bidding process among for-profit companies and nonprofit organizations leading to selection in 2023 of three Medicaid contractors. Recipients of those contracts would share responsibility for delivering $3.9 billion in services to low-income children and adults as well as people with physical, intellectual or developmental disabilities.

The current contracts expire at the end of 2023, but legislation pending in the House would extend those deals to the end of 2025.

Rep. Brenda Landwehr, a Wichita Republican and chairwoman of the House Health and Human Services Committee, said the goal of the bill was to enable the Legislature to seize greater control of KanCare during a period covering the gubernatorial election and a portion of the next four-year term of a governor.

“The idea is to give whomever the next administration is the opportunity to go into long-term contracts with KanCare,” Landwehr said. “By extending it, then the next administration comes in and deals with it. That’s the intent.”

KanCare, the state’s privatized system of Medicaid, was launched in 2013 by Republican Gov. Sam Brownback. He extended the initial KanCare contracts by issuing an executive order, not by permission of the Legislature. Sunflower State Health Plan and United Healthcare have been KanCare contractors from the start. In 2018, GOP Gov. Jeff Colyer announced selection — seven months before his term as governor ended — Aetna Better Health of Kansas would replace the third original KanCare contractor Amerigroup Kansas.

Under House Bill 2463, the executive branch in Kansas would not have authority to make “substantive or material” changes to Medicaid until Jan. 1, 2026.

It would order the Kansas Department of Health and Environment to negotiate contract extensions with Sunflower, United Healthcare and Aetna. KDHE would be forced to seek federal approval to continue operating KanCare in the manner of an experimental program, but the state’s Medicaid director said any request for an extension of federal authorization beyond one year would be rejected by the U.S. Centers for Medicare and Medicaid Services.

Rep. Kathy Wolfe Moore, a Democrat from Kansas City, Kansas, said the bill deviated from a process established by Republican governors in which the executive branch took the lead in developing contracts with managed-care companies. So far, Kansas governors have guaranteed Medicaid recipients three options among MCOs.

She said the bill risked the state running afoul of federal regulators and jeopardized $2.9 billion in federal funding for Medicaid. A law requiring contracts with specific companies would soften the state’s leverage in management conflicts, she said.

“This would set up a no-bid process because these contracts would automatically stay. I’d love to be a contractor with the state if I knew I could do anything,” Wolfe Moore said.

 
 

Rep. Kathy Wolfe Moore, a Democrat from Kansas City, Kansas, expressed concern about a bill forbidding until 2026 a new round of competitive bidding on state contracts with Medicaid managed-care companies. A Republican legislator said the objective was to block progress until voters decided in November whether to give Democratic Gov. Laura Kelly a second term. (Sherman Smith/Kansas Reflector)

 
 

Political motivations?

Kelly, who is seeking re-election to a second term as governor, has supported proposals to expand Medicaid eligibility to include at least 100,000 more Kansans. So far, the House and Senate have not consented to expand access to Medicaid. Kelly’s likely Republican opponent in November would be Attorney General Derek Schmidt, who has opposed Medicaid expansion and authorized legal challenges of the Affordable Care Act.

None of the current KanCare contractors expressed support for the bill during the public hearing in Landwehr’s committee. Two Cabinet secretaries in the Kelly administration, the state’s Medicaid director and representatives of four health advocacy organizations opposed the legislation. Three organizations, including the Kansas Medical Society, raised objections but didn’t declare outright opposition.

Legislators were puzzled by absence of testimony from any organization or individual making arguments in support of the bill.

“It’s a little bit difficult when we don’t have a proponent,” said Rep. Doug Blex, a Republican from Independence. “The benefit of committee work is to hear all sides and make a somewhat intelligent decision.”

Democratic Rep. Susan Ruiz, of Kansas City, Kan., added: “I’m used to bills coming to us because we want to fix something or we want to enhance something. This is just out of that realm.”

GOP Rep. John Eplee, a physician from Atchison, said he was struggling to nail down purpose of the bill.

“I understand this is well-intentioned to provide more legislative engagement and oversight with this program,” Eplee said. “Without proponent testimony it’s a little hard for me to really embrace what the goal of this bill is.”

 
 

 
 

Sarah Fertig, Medicaid director at the Kansas Department of Health and Environment, said financial and legal problems would result from passage of a bill mandating extension of state Medicaid contracts with three companies until 2026. She said the bill jeopardized $2.9 billion annually in federal aid to Kansas. (Kansas Reflector screen capture from Kansas Legislature YouTube channel)

 
 

‘Uncertain, far-reaching’

Kansas Medicaid director Sarah Fertig, who is part of the Kansas Department of Health and Environment’s division of health care finance, said the federal government wouldn’t let Kansas secure more than a one-year extension of its current authority to operate KanCare.

KanCare functions under a so-called Section 1115 waiver of federal rules scheduled to expire Dec. 31, 2023. However, the bill would require the Medicaid program to remain frozen through Dec. 31, 2025, which would be two years after the state’s Section 1115 waiver expired.

She doubted federal officials would approve a “two-year, no-bid contract extension for our three MCOs in the absence of a clear operational need.”

Vague language of House Bill 2463 had “uncertain and far-reaching implications” on operation of Medicaid in Kansas, Fertig said.

If made into law, she said, it could interfere with adding new drugs, treatments and services to Medicaid coverage. It could block increases in medical provider reimbursements. It would interfere with extending coverage for postpartum women, behavioral health services and therapy for children with autism.

It would forbid the state from addressing workforce shortages for individuals working to care for people with disabilities. A prolonged hold on new contracts could jeopardize federal funding that made up two-thirds of the state’s Medicaid budget, she said.

“If even a portion of federal funding were lost as a result of the state’s compliance with HB 2463, the results would be devastating,” Fertig said.

DeAngela Burns-Wallace, secretary of the Kansas Department of Administration, said the House legislation could be problematic if it forced the state to extend contracts with a vender it no longer wanted to do business with.

“Language of the bill indicates that no substantive or material change can be made in the contracts. Vendors could argue that the state must retain the current vendor regardless of the vendor’s performance,” Burns-Wallace said.

 
 

 
 

Rachelle Columbo, executive director of the Kansas Medical Society, said legislation freezing Medicaid managed-care contracts until 2026 should include a provision allowing an increase in fees paid physicians caring for KanCare patients. Rates haven’t changed since 2006. (Sherman Smith/Kansas Reflector)

 
 

‘Harmful rigidity’

KanCare Advocates Network, a coalition of more than 50 organizations and individuals who advocate on behalf of participants in Medicaid, argued the House bill would unnecessary pump the brakes on broadly supported reforms of KanCare. Years of opportunity for progress could vanish, said Sean Gatewood of KanCare Advocates Network.

“The bidding process by the MCOs is needed to constantly adapt to the current environment as well as improve the overall system on a regular basis,” Gatewood said. “At the core of the KanCare program is the premise that competition will drive better outcomes. HB 2463 removes most of that competition.”

Denise Cyzman, chief executive officer of Community Care Network of Kansas, said 28% of patients at the network’s 34 clinics were covered by Medicaid. The network provides medical, dental, pharmacy, mental health, substance use disorder and case management services.

“The COVID-19 pandemic has demonstrated how important it is for our health care system to be nimble and adaptable. HB 2463 not only discourages adaptability, but imposes an unnecessary and harmful rigidity to the system,” she said.

 
 

Clipped from: https://kansasreflector.com/2022/02/04/house-bill-delays-rebidding-states-3-9-billion-medicaid-contracts-until-after-governors-race/

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SD- Medicaid expansion fund gets Senate’s OK

MM Curator summary

[MM Curator Summary]: One SD legislator wants to start a savings fund to pay for Medicaid expansion if it passes the ballot.

 
 

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.

 
 

 
 

PIERRE, S.D. (KELO) — The possibility that South Dakota might expand Medicaid eligibility to 138% of the federal poverty level has spurred at least one side of the Legislature into preparing for it.

State senators voted 21-14 Tuesday to create a special fund where money could be set aside to help cover future costs that state government would gradually face.

“It’s only triggered if we do,” said Senator Wayne Steinhauer, R-Hartford, adding that expansion looks “very likely” at the ballot box. He’s prime sponsor of SB 102, which goes to the House next.

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A coalition of groups led by South Dakota’s largest healthcare providers gathered signatures to put the expansion question on the ballot in November. Republican legislators last year, trying to pre-empt it, put a question on the June primary ballot that if passed would require any future measure that causes state government to spend at least $10 million per year to get at least 60% support to take effect. Steinhauer voted for putting the 60% requirement on the ballot.

He said Tuesday he wants to avoid “a financial shock to the system” if expansion passes. The fund would be used to create a reserve that could be drawn upon.

Senator John Wiik, R-Big Stone City, opposed creating the fund. He’s a member of the Joint Committee on Appropriations that establishes state government’s annual budget. Wiik warned, based on past events, that appropriators could sweep money from the Medicaid fund. “Any time there’s a down year, that money can go away,” he said.

Senator Jean Hunhoff, R-Yankton, defended establishing the fund. She chairs the appropriations panel. She agreed it’s unclear whether enough voters will support expansion. “The fact we do know is it is on the ballot,” she said. She added, “There are going to be additional costs to the state of South Dakota. There’s no question about that.”

The Legislative Research Council has estimated five years of costs if the expansion occurs. Every year is well over $10 million.

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“The public wants to know we’re doing this right,” Steinhauer said.

Senators also voted 34-1 for legislative approval of HB 1103 that calls for the state government to establish Medicaid schedules for dental, eye and chiropractic care. The state Department of Social Services opposed the bill at its House hearing but didn’t testify at the Senate hearing.

 
 

 
 

Clipped from: https://www.siouxlandproud.com/news/south-dakota-news/south-dakota-medicaid-expansion-fund-gets-senates-ok/