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Medicaid Updates August 28, 2013

Medicaid Updates August 28, 2013. Patrick Stephan Lori Horvath. FY 2014 Medicaid Priority work areas . Medicaid Priority initiatives . I mplement changes in the ICF-IID program to move towards vision outlined in white paper and budget agreement

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Medicaid Updates August 28, 2013

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  1. Medicaid Updates August 28, 2013 Patrick Stephan Lori Horvath

  2. FY 2014 Medicaid Priority work areas

  3. Medicaid Priority initiatives • Implement changes in the ICF-IID program to move towards vision outlined in white paper and budget agreement • Amend IO and Level 1 waivers to incorporate policy and rate changes • Develop long-term strategy for the TDD Waiver • Revise the ICF Level of Care rules to consolidate our approach to ICF/IID and waivers • Continue work & evaluate progress of the “Weekly Rate Pilot” and the Imagine Project 3

  4. Waiver amendments on the horizon

  5. Individual Options Waiver • Awaiting CMS response for community integration add-on which would expand existing DC add on- to two years • Investigate Direct Care hour limitations • Nursing services in the IO Waiver • Quality Incentive Payments in the IO 5

  6. IO and Level One Rates • FY 14 $5.4M to increase direct care wages • Workgroup proposes increase to on-site/on-call and transportation • Target date 1/1/14 dependent on Waiver amendments approval • Rule timelines • IT changes 6

  7. Transitions DD Waiver

  8. Transitions DD Waiver • Carestar to complete PEATs for individuals with waiver start dates through 12/31/13. • County boards to complete level of care for individuals with span dates 1/1/14 or later • Equipment process: • Alternative resources • Medicaid reviews • Maximum reimbursement rates 8

  9. Transitions DD Waiver • OHCW Waiver Disenrollments: What we know today 9

  10. Transitions DD Waiver • Workgroup begins 9/17/13 to develop a TDD amendment package • Future of TDD in the service delivery system • Phase-out plan? • Service changes • Provider qualifications 10

  11. State Plan Authorizations

  12. State Plan Services • New authority to complete private duty nursing (PDN) acuity and determine amount of PDN to incorporate in waiver plans • Trainings begin in September • Additional sessions to be available in metro areas, as well as webinars • No changes are being made to the process for accessing services for individuals not enrolled in waivers 12

  13. State Plan Services • State plan home health services may include incidental services (household tasks) along with hands-on assistance with personal care or health-related tasks • Incidental services may not “substantially extend” the visit • State/federal rules do not define the amount of time which may be spent on incidental services during a visit 13

  14. Additional

  15. Additional • Level of care: Piloting by ICFs and county boards continues. Implementation expected to occur in spring/summer 2014 • MSS Technical Guide has been developed and will be posted to the Medicaid tab of DODD’s website • SELF Waiver: Regional support broker trainings conducted by COGs. Registration is available on DODD’s website 15

  16. Level One Waiver reminder • Amendment changes effective 9/1/13 • Additional services • Community respite • Remote monitoring/equipment • Home-delivered meals • Cost cap increases from $6,000 - $7,500 over 3 years

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