Medicaid Advisory Committee
/ Date: December 4, 2012Time: 10:00 am – 12:00 pm
Location: DHHS Offices, Conference Room C, 41 Anthony Ave Augusta, Maine
Sara Squires started the meeting and announced that Ana Hicks has taken another job and Sara is filling in until a new chair has been chosen.
Sara talked aobut having the discussion on the new chair during the January meeting. However, the January meeting falls on January 1st. Should we move the meeting and have the discussion then? The group decided on Tuesday, January 8th. Sarah will ask Mary Lou to facilitate the meeting as she will not be available on that day.
Rose gave an update regarding the MaineCare redesign task force. The group recommended smoking cessation and dental for pregnant women. These recommendations were not accepted. The final meeting is December 5. From 1-3, there will be a public comment, than the final report will occur after the public comment. The proposal is that care management would address the top 20% of the MaineCare users.
There was some discussion on the Health Insurance Exchange- Any additional information about coordinating the health exchange? How will the federal government help Maine? Please keep the MAC group informed. How many states are in the same place as Maine? There are about 20 states. Per Katie from CMS, there are more states deciding to expand. The numbers will be changing as more time goes by. She is expecting the numbers to go up overall.
Chapter 90 that the state passed, are there solid numbers that have been shared. CAHC will provide a Winners and Losers report.
OFI Update: Doreen McDaniel’s- Non catagorical status- October enrollment continues to go down and is currently at 11,532. This is down from September- 12,050. Waiting list is at 22,515. The new numbers will be coming out in the next couple of days.
Proposed rules: 261p changes to Medicaid eligibility. 262 Change in DEL eligibility. We are still awaiting a decision from CMS regarding the SPA.
School-based Update: Amy Dix
Added Nursing services provided by an RN or LPN. Trying to finish up specialized transportation, still working on this and looking at what other states are doing.
BHP update: The proposal is to blend the BHP Curriculum and the Personal Care Assistant Curriculum. This would be the day treatment staff that would have this training either by the schools or an outside agency. The goal is to have less training hours, but a more relevant curriculum. Amy looked to the group for input on this proposed solution. There would be new rates set up for these services. How would this fit in with the departments emerging concept of PC services? There will need to be a review with the other PC-related initiatives.
Day Services- Local school is responsible for the Seed, why is that? This is a controversial issue as to weather this is a medical or educational service. Amy will follow-up on this as it affects Property Tax vs. Sales Tax.
Policy Update: Pascale Desir - Please see Rule Status update document.
Changes/Updates Physician Services. There was a fiscal impact that we are still waiting on. This will not be sent until next week. The PCP ACA PIP rate increase will be added. How will the rate increase be determined? Pascale will touch base with Dr. Flanagan and will let everyone know how it is determined. Will this go to an RFP for testing? Not sure. One of the ways this information was derived was using information from the CDC.
Section 113- Transportation Time frame has been pushed back. This is a work in progress.
Pharmacy Services- Adding language to the rule restricting the amount of oppiod medication that can be received regarding treatment for pain.
Section 85- Add language to reflect some of the changes that will be happening related to pain management
State Plan: 1113- Approved November 8th of this year.
Fiscal Impact of 12011- Hospital Outpatient, this was budget neutral.
There are two new policy writers. Matt Galletta, moved from the PERM unit. Peter Kraut- Policy writer for Physicians, Health Homes, and FQHC/RHC.
Amy Dix- will be leaving the Policy unit, she will be management CHIP. She will be keeping the schools project.
How long should items remain on the Rule Status list? The group discussed and decided that it should be removed when they are adopted. Reporting by title only when it has been approved.
Section 32 Update? There is no update on this; I will follow-up with Teresa Barrows about this.
Project Update: Kitty Purington
VBP- Stage A Health Homes. Individuals with chronic conditions update. Still planning to implement Stage A on January 1st. The SPA has been submitted and has been received and questions are back from CMS that we are working to respond to.
Opened up Health Homes enrollment until 12/14 and delayed the date that NCQA recognition is required. The application process was re-opened to get additional provider sites for Health Homes.
Letters are being sent to MaineCare members to let them know that they are currently seeing a primary care provider that is a member of a HH practice and that they can opt out of they do not want the service. Second wave of letters is an opt in letter, if they want to be in a Health Home and they are not currently. Members do not have to change providers if they do not want to, it is the member’s choice. Kitty has a draft of the letter that she can share.
There is an expectation of 75 confirmed Health Homes and up to 50 additional Health Homes. Hoping by opening up there will be some additional ones.
Stage B- Getting a request for information for Stage B. Committed to getting in out in the next 10 days.
ACOs-
Had a few conversations with CMS regarding concept paper. This is still in the initial stages. Implementation is still scheduled for April 1st.
Transportation Update: Brian Sullivan
Received 34 total applications for transportation brokers across Maine. The scoring process of these applications has started. Deadline is the end of this month. Go-live date (with exception of appeals), would be looking at mid-February to March 1st for go-live date. Goal is to get this up to date within 60 days of the letters.
Next Months Agenda
New Chair
PMNI Presentation
-what is happening on NON-C appendixes.
-MaineCare services being RFPed?
-Project Update