State News 01/06/20

Medicaid, Medicaid expansion, MLTSS

Iowa – (Quad-City Times, 01/03/20) The state is withholding $44 million from its newest MCO, Iowa Total Care, owned by St. Louis-based Centene and brought in this past summer citing incorrect payments to providers and internal record keeping.   Iowa Medicaid Enterprises Director Michael Randol said the Department has worked in good faith and has given Iowa Total Care ample time to correct claims and encounter data errors.  According to the letter sent by the Department to notify Iowa Total Care of the withhold, 106,000 unpaid claims are central to the decision to withhold the monthly capitated payment to the MCO and will be reevaluated at the end of February.  At least 75% of these claims will need to be resolved for the state to release payment.

Kansas – (Kansas City Star, 01/02/20)  Gov. Laura Kelly has confirmed that her office is in talks with Senate Majority Leader Jim Denning on a Medicaid expansion deal.  Denning’s Chief of Staff stated that he expects an expansion plan to be filed before the beginning of the legislative session and that it will be one in which everyone wins.  Denning’s plan features a “dual-track approach that expands Medicaid and provides re-insurance to health plans sold on the federal exchange”. This means that Kansas would provide insurance to insurance companies, thereby incentivizing them to participate in the exchange with lower premiums. Democrats are concerned that Denning’s plan is overly complex, and Republicans are disappointed that it does not include work requirements.

Michigan – (WWJnewsradio, 01/02/20) Effective January 1^st, participants in the state’s Medicaid expansion program are now required to be actively engaged in some productive activity for at least eighty hours per month.  Such activities include having a job, being a student, looking for a job, volunteering (this activity can only be used for three months each calendar year), doing job training, participating in a tribal employment program, participating in rehab (substance abuse), doing vocational training, or doing an internship. It is expected that at over 500,000 people will be affected by this rule.

State Budget

New York – (Skilled Nursing News, 01/03/20) In the face of a projected $6 billion dollar deficit, the state has issued a 1% cut to Medicaid payments for services delivered from January 1 thru March 31, 2020 and each year forward.  The estimated annual net aggregate decrease in gross Medicaid expenditures from the cuts will be $124 million in the current state fiscal year with decreases of $496 million in each state fiscal year thereafter.  Cuts effecting nursing homes, hospitals, physicians, pharmacists, home care entities and Medicaid managed care plans were noticed in the New York State Register on December 31^st, 2019.

Rhode Island – (Newport This Week, 01/05/20) As members of the General Assembly ready themselves for the upcoming legislative session, two Newport area electeds cite people with intellectual and developmental disabilities and non-profits serving them as key areas needing attention and support. Democratic House Finance Committee Chairman, Marvin Abney says he “will strive to ensure that the critical needs of our nonprofits, large and small, are well represented and supported by the General Assembly”.  And Senate Finance Committee Vice-Chairman, Louis DiPalma, a long-time champion for people with I/DD was quoted saying, “Our budget defines our state’s priorities. To ensure we appropriately address the needs of our state’s most vulnerable populations, individuals with intellectual and developmental disabilities…we need a strong economy.” The 2020 legislative session kicks-off Tuesday, January 7^th.