Medicaid
Medicaid, SIM committee update – PCMH success continues, SIM making important Medicaid decisions
The Care Coordination committee of MAPOC has been given responsibility for oversight and advice on SIM’s controversial new plans for Medicaid, especially the shared savings payment model. The committee’s original mission remains as well – to track Medicaid’s successful patient-centered medical home program. In yesterday’s meeting we heard more about continuing PCMH success. The number…
Read MoreCTNJ Op-Ed: Medicaid spending myth driving unhealthy policies
An Op-Ed published in today’s CT News Junkie debunks the persistent, old (pre-ACA) myth that state spending on Medicaid is “out of control”. Unfortunately that myth is driving SIM policymakers into a risky shared savings payment model that is unproven, ill conceived and wouldn’t make much difference in the state budget even if it worked.
Read MoreMore CT Medicaid benefits from dropping insurers – no ACA taxes
Because CT dropped insurers from our Medicaid plan three years ago, we are not subject to the ACA tax on insurers saving state taxpayers more than a billion dollars over the next decade. The ACA tax on fully-insured plans is due for the first time September 30 and will cost fully-insured states $700 million just this…
Read MoreCMS stopped reimbursing CT for new Medicaid eligibles in January
CT News Junkie reported today that CMS halted reimbursements for the newly eligible Medicaid members as of January 1st. The first quarter payment the state missed was $249 million, but the second quarter amount could be more as enrollment grew under the ACA expansion starting January 1st. According to DSS’s financial reports, the state’s expected…
Read MoreCSG/ERC panel on Medicaid innovations
Today’s health committee meeting at the CSG/ERC annual meeting in Baltimore featured updates from NY and CT about what is working in state Medicaid programs, and an update from CMMI on what’s next for the State Innovation Model program. Sen. Terry Gerratana moderated the panel that included Asm. Richard Gottfried (NY), Olivia Puckett (MAPOC) and…
Read MoreCMS announces new assistance for states to improve health system, many SIM alternatives
Today CMS unveiled the Innovation Accelerator Program providing states with over 50 tools, programs and technical assistance to improve Medicaid programs – both delivery and payment reforms. SIM is only one of the dozens of tools listed. The tools include numerous alternatives to CT’s risky SIM proposal to achieve every one of the goals outlined…
Read MoreSIM moving ahead with risky Medicaid plan despite 25 advocates’ objections
At yesterday’s meeting, the SIM steering committee chose to move ahead with plans to radically change the Medicaid program – to include shared savings and an 1115 waiver. The new plan, rushed out in only a few weeks, reverses earlier assurances to advocates that the state would go slowly into shared savings payment incentives, recognizing…
Read MoreMedicaid Council voices concerns about new SIM proposal
In a special meeting yesterday, the majority of Medicaid Council members voiced concerns about the rushed, new SIM proposal for Medicaid. Legislators compared the new proposal to the failed HUSKY HMO proposal 20 years ago and made it clear that they are concerned about “going back down that road”. Concerns included the application’s aggressive pace of…
Read MoreQuestions for SIM about radical new Medicaid proposal
Questions sent yesterday for today’s meeting about SIM’s risky, new Medicaid proposal have been posted. One asks why a dangerous 1115 waiver is necessary? Did SIM planners explore other, less dangerous options? 1115 waivers necessarily include a cap on federal reimbursement (to meet the federal budget neutrality requirement) endangering the state budget and potential future…
Read MoreSpecial Medicaid Council meeting on new SIM Medicaid plan
The very new SIM plan for Medicaid will be the subject of a special MAPOC meeting tomorrow July 8th at 9:30 in Room 2C of the LOB. Concerns have been raised about both the content and the process for this radical departure from the original SIM plan for CT’s largest health plan. We expect more…
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