Medicaid
Medicaid Managed Care Council Update
First, at Friday’s meeting the Council decided to meet in August (on Friday the 13th) – we rarely do that – because of the many challenges and opportunities facing the program. At the meeting, DSS reported that they have sent a letter to CMS seeking guidance about how to move HUSKY from the current, controversial…
Read MoreCT visit from the FMAP van, nursing homes without air conditioning, and more Medicare donut hole checks mailed
Wednesday the Driving for Quality Care RV stopped in Manchester to bring attention to Congress’ failure to pass an extension of the FMAP increase. FMAP is the matching rate the federal government pays CT for Medicaid spending. The 2009 federal stimulus bill raised the rates for all states, but that increase is scheduled to end…
Read MoreUtah program reduces non-urgent Medicaid ER visits by 55%
Safe To Wait, a Utah Medicaid educational program, reduced non-urgent visits to emergency room visits by 55%. Medicaid savings for some patients were as high as $156/month. In the Safe to Wait program, members were provided with information on which conditions were true emergencies and which could wait. After the first non-urgent ER visit, members…
Read MoreJudge denies parts of nursing home lawsuit
A federal judge has denied an injunction in the CT Association of Health Care Facilities’ lawsuit against the state, but the lawsuit is moving forward. The nursing homes had asked for an injunction to stop $300 million in cuts scheduled over the next two years; the state asked the court to throw out the entire…
Read MoreMedicaid Managed Care Council update
Friday’s Council meeting focused mainly on plans for the $50 million temporary high risk pool opportunity created by national health reform. DSS joined the CT Insurance Dept. and the Health Reinsurance Association (HRA) to describe their plans. They intend to piggyback on the current high risk pool administered by HRA which was created in 1976…
Read More$266 million in Medicaid funding at risk
Congress is considering a bill that extends the badly needed enhanced Medicaid matching rates to states for another six months. Without the legislation, the extra funding is set to expire at the end of this year. CT stands to lose $266 million in federal funds. Along with thirty other states, CT has assumed receipt of…
Read MoreOnly CT and DC take early expansion option
To date only CT and the District of Columbia have submitted early option applications to expand Medicaid under the new federal health reform law. CT applied April 15th and DC submitted their application May 13th. CT plans to cover our 45,000 SAGA members under Medicaid, providing expanded coverage and eliminating the SAGA asset test, while…
Read MoreMedicaid Managed Care Council update
We ran out of time at Friday’s Council meeting, so we will devote the entire June meeting to discussing how the state plans to implement the new budget provision to self-insure the HUSKY/SAGA/Charter Oak program. Some of the decision points are whether to keep the program capitated but without financial risk (not sure how that…
Read MoreBudget agreement reached
The Governor and General Assembly have reportedly reached an agreement on changes to next year’s budget, beginning July 1st, to cover a $2 billion deficit. The agreement includes converting HUSKY to a self-insured ASO model saving $77 million and increases in copays and premiums for HUSKY Part B families, saving $576,000. The legislature is expected…
Read MoreBHP initiative reduces hospital delay days by 22% in two years
At Wednesday’s Behavioral Health Partnership Oversight Council meeting, Value Options, DCF, DSS and eight hospitals announced remarkable progress in reducing the number of HUSKY children in discharge delay at hospitals, ready to leave but waiting for appropriate outpatient behavioral health care. The initiative aligned performance incentives across providers and administrators. During 2007, before the initiative,…
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