Waivers
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As Legislators Wrestle to Define Next Generation of Florida Medicaid, Benefits of Reform Effort Are Far From Clear
Medicaid is a critical part of Florida’s health care system. It covers about 27% of the state’s children, pays for 51% of all deliveries and nearly 66% of nursing home days. In 2006, a five-year pilot program replaced traditional Medicaid with an unusual managed-care model and other features that required a Section 1115 waiver from…
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A Closer Look at Florida’s Medicaid Program
The Florida legislature is in the midst of a hot and heavy debate about the future of the state’s Medicaid program. One of the key questions being discussed is whether or not to expand the state’s controversial Section 1115 Medicaid waiver across the state and across all populations. The waiver is coming to the end…
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As ACA Approaches 1st Birthday, Legislative Activity Heats Up
Both the Senate Finance Committee and Health Education Labor and Pensions Committee held hearings this week on aspects of the Affordable Care Act. Here’s a quick summary of those hearings and other developments in Congress. In the Senate Finance Committee hearing, Secretary Sebelius did a good job of responding to criticism of the ACA by…
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Waiving Hello to State Innovation?
By Joe Touschner In a continued push to show that states have flexibility under the Affordable Care Act, the Departments of Health and Human Services and the Treasury this week proposed rules for states to apply for innovation waivers under section 1332 of the ACA. Under current law, states could negotiate a waiver of ACA…
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What did the President Just Say??
On Monday, while addressing the nation’s Governors, President Obama endorsed bipartisan legislation introduced by Senators Wyden, Brown and Landrieu that moves up the date that states can apply for so-called “State Innovation Waivers” from 2017 to 2014. Waivers come in many shapes and sizes and can be quite confusing. (Just watch Members of the House…
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Arizona Waiver Situation Not Applicable to Other States
Governors from states considering balancing their budgets on the backs of their most vulnerable residents should not read too much into Secretary Sebelius’ letter to Governor Jan Brewer this week. HHS Secretary Sebelius did not waive the stability protection (aka “maintenance of effort”) provisions of the Affordable Care Act as Governor Brewer had requested. Secretary…
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Just Say No to Arizona’s Waiver Request
Thanks to the more than thirty national organizations that joined CCF in expressing our opposition to Arizona’s request to waive the maintenance of effort provisions that are currently preserving stability in states’ Medicaid programs. Groups such as the American Academy of Pediatrics, Center on Budget and Policy Priorities, Easter Seals, Families USA, the National Association…
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MEDICAID MATTERS: Arizona Section 1115 Waiver Request Sets a New Low
I recently pulled out my copy of the Social Security Act to reread Section 1115 which provides the Secretary of Health and Human Services with the authority to permit waivers of certain rules of the Medicaid program. These projects were conceived of by Congressional drafters as “demonstration projects” or “experimental pilots” which “in the judgment…
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Florida’s Proposed Medicaid Long-Term Care Changes Raise Host of Questions About Impact
Florida’s 2011 Managed Care Legislation, HB 7107, established “Medicaid Managed Care,” a new statewide managed care program for all covered services. Two separate components are anticipated for the new program: the Florida Long-Term Care Managed Care program, slated for implementation first, and the Florida Managed Medical Assistance program, an expansion of the Medicaid pilot program…
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Comments on Public Process Submitted to CMS: Waiver Watchers Rise to the Challenge!
Today the attached comments on the proposed federal regulations on public process for Medicaid and CHIP demonstration waivers were submitted to CMS. A diverse and well-respected list of 79 groups – including 48 national and 31 state groups — joined the effort by signing onto CCF’s comments. In addition, the Consortium for Citizens with Disabilities…
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Dropping Out of Medicaid? Wyoming Has Taken a Look at the Consequences
By Martha Heberlein An idea has been floating about suggesting that states that don’t want to comply with the new Medicaid provisions will simply “opt out” of the program. While much of the recent chatter has centered on Texas, Governor Freudenthal of Wyoming asked his Department of Health to examine the issue back in March.…
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Waiver Watchers – We Need You More Than Ever
One of the consequences of the election, I believe, is that given the significant number of opponents of health care reform who were elected as Governors and/or Insurance Commissioners, we are going to see more “waiver” proposals. Even before the election, Senator Orrin Hatch (R-UT) was talking up the prospect of seeking legislation to allow…
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Calling All Medicaid ‘Waiver Watchers’
I know you’re out there because our blog editor assures me that “section 1115 waiver” is one of the top 50 search terms leading readers to Say Ahhh! As I blogged about a few weeks ago, CMS recently released proposed regulations as required by ACA that establish a more robust public notice and comment process…
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Transparency in the Section 1115 Waiver Process: Proposed Reg is Released!
This is sad — I was sitting outside my daughter’s school waiting for a friend this morning avidly reading Friday’s Federal Register. For those of you who missed it, the proposed regulation implementing new transparency and public notice procedures for Section 1115 Medicaid and CHIP waivers was released on September 17th, 2010. I think my…
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PART 2 ON THE ROLE OF WAIVERS IN THE NEW WORLD: A LONG AWAITED VICTORY – MORE TRANSPARENCY!!
So as Part 1 described it is a little hard to predict what the role of waivers will be in the new world. But one thing we do know is that more standards regarding transparency and public participation are coming our way. And they are coming soon – one of the first things out of…
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THE ROLE OF WAIVERS IN A NEW HEALTH REFORM WORLD (PART 1)
One of the many questions I have asked myself since passage of the Patient Protection and Affordable Care Act is what the role of Section 1115 waivers will be come 2014 when the major provisions of PPACA are implemented. In the past, Section 1115 waivers have sometimes been used to expand coverage to groups previously…
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Rhode Island’s Medicaid Waiver: A Bad Deal for the State
In August 2008, Rhode Island applied for federal permission to radically transform its Medicaid program. Rhode Island asked for a fixed amount of federal funds each year along with permission to bypass longstanding federal standards protecting Medicaid beneficiaries. However, the terms and conditions of the waiver fail to take into account the impact of the…
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Florida’s Experience with Medicaid Reform: What has been Learned in the First Two Years?
Two years after the launch of Florida’s Medicaid reform pilot it appears that beneficiaries’ access to heath care has worsened and financial benefits for the State of Florida remain unknown. Beneficiaries and providers think the Medicaid program has become more complex with more paperwork as a result of reform, and there are signs that access…
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Rhode Island’s Global Compact Waiver
Author: Joan Alker Joint Session of the Rhode Island House and Senate Finance Committees Testimony Document August 5, 2008
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Florida’s Medicaid Reform Pilot Programs: Challenges with Mental Health Services
People with disabilities and chronic conditions, including persons with mental illnesses, present challenges for managed care organizations. As the Florida Legislature, other policymakers and the public track the Medicaid reform pilot programs, it is important to assess how this unique managed care model works for some of the diverse populations affected by reform. This policy…