Oklahoma: Medicaid Managed Care Considered for the Aged, Blind, and Disabled
As part of the Oklahoma Health Care Authority’s (OHCA) efforts to explore cost-saving options for its aged, blind, and disabled (ABD) Medicaid population, the agency is evaluating 23 “request for information” responses from managed care companies, administrative service organizations and regional healthcare groups interested in coordinating their care. Supporters of H.B. 1566—the bill that directed OHCA to request vendor proposals—have promoted the potential savings from transitioning the $2.4 billion program to managed care, but consumer advocates have voiced concerns about disruptions in care. Oklahoma established a Medicaid managed care program in 1995 but it was ended in 2004 once the ABD population was added to the program and health plans began leaving, citing insufficient capitation rates. October 2017 is the earliest the new program would launch.
South Dakota: Governor Advances Medicaid Expansion Paid in Part with Increased Use of Indian Health Services
Governor Dennis Daugaard (R) is moving forward with a Medicaid expansion plan that seeks to offset the cost of expansion in part by increasing utilization rates of Indian Health Services, which are fully funded by the federal government. To do so, South Dakota intends to make the IHS services more accessible to ensure those who are eligible are not seeking care from outside providers unnecessarily. Other expansion goals include improving access to care for all enrollees, and to preventive care services on reservations in particular. The Governor’s office reported that HHS Secretary Burwell expressed openness to the plan during a meeting with the Governor, according to the Argus Leader. The Governor’s senior advisor said that expanding Medicaid would extend coverage to 48,500 individuals and cost the State up to $33 million per year starting in 2020.
Texas: State Requests Extension for Delivery System Reform Incentive Payment Program
Texas submitted a five-year extension application for its Healthcare Transformation and Quality Improvement Program 1115 Waiver, which allocates funds to the State’s hospitals and providers through an uncompensated care pool and a Delivery System Reform Incentive Payment (DSRIP) program. The extension application requests $35 billion in uncompensated care funding, almost twice the amount provided under the current waiver and approximately $15 billion ($3.1 billion per year) to continue the DSRIP program at its 2015-2016 demonstration year funding level. CMS and Texas officials have until September 2016, when the current waiver expires, to reach an agreement.
Utah: Medicaid Expansion Details to Be Publically Released
Lawmakers had their first look at “UtahAccess+,” the new Medicaid expansion plan assembled by the “Gang of Six” (comprised of Governor Gary Herbert (R) and Republican legislative leaders) during closed-door Republican House and Senate caucuses. While details are set for public release during the first Health Reform Task Force meeting, media sources report that UtahAccess+ relies on provider taxes (including on managed care organizations, prescription drug companies, providers of psychological and home health care services, podiatrists and others) starting in 2017 to pay for the State's eventual 10% share of the federal program, a maneuver supported by the Utah Hospital Association but opposed by most other provider groups. The Governor’s “Healthy Utah” plan, which previously passed the Senate but failed in the House, was exclusively funded by public taxes. Governor Herbert commented that changes may be needed to the State-share funding mechanisms for the plan to pass, especially through the supermajority Republican House.