NM Congressional delegates call for input in preparation for Moday 01/28/13 CMS Conference Call

From the Center on Law and Poverty:

 

Below is info just received from Quela re information needed by D.C. offices by Monday.  Please send your responses directly to Fern Goodhart.  Don’t have Sandra Wilkniss’ email address right now but as soon as I receive it will get it to you.  It’s disheartening and troubling to have been told that the tribes’ issues would be taken under advisement and then learn it is likely that CMS will render its decision on Monday.  The congressional offices are especially interested to have outcome data of any kind.  I know that these kinds of data are for the most part not available in any reporting format so if what you have is anecdotal that has to be what will be authoritative.

 

Regis Pecos will be arranging a meeting with the Indian legislators on Monday (not completely firm) to hear from you about concerns and issues related to Centennial Care.  He would like to have information about the matter to present to them.   They will be asked to send a letter or call the congressional delegation to reinforce the tribes’ stand.  I will make sure that Regis has the CMS summary, Jemez Letter, Ohkay Owingeh and NMICoA statements right away to help him with the invitation to the legislators.  Can we break up the work in this way?  Ken, view from a direct IHS service tribe; Erik and Ron, native community group; Anthony, developing tribal health system and Maria, tribal medical health home; April will provide an overall tribal position.

 

Sorry that these requests come with such short notice but CMS’ move is the familiar say one thing and do another that is characteristic of our trust relationship.   

 

Thanks, Evelyn

 

From the Center on Law and Poverty to Congressional delegation representatives:

 

Dear Sandra and Fern,

Thanks so much for speaking with me today, Sandra! Per our conversation, please find attached a few documents that should help inform your discussion with CMS on Monday re: mandatory enrollment of Native Americans in managed care under Centennial Care. The recent letter to state tribal leadership from Jemez Governor Madalena is a great place to start with getting up to speed with our most pertinent concerns. The CMS summary of the November tribal consultation illustrates our concerns in greater detail. Finally, the attached response from HSD regarding the November consultation indicates that their solution is to outsource all responsibility for the issues we've raised to the MCO's. The MCO's that we have yet to receive any information about due to the procurement process.

Tribes remain open to discussion of the following solutions: an opt-in -NOT opt-out option; a demonstration or pilot Centennial Care project using the Native Americans currently enrolled in Medicaid managed care or sample population with an evaluation process that will then determine the appropriateness of a launch to the entire population; and, means by which a large tribal provider such as the Navajo nation may become a tribal MCO. This is not a comprehensive list, and tribes are eager to meet with CMS again to discuss these and other possibilities. As it stands, however, tribes are uniformly opposed to mandatory managed care. Our organizer at CLP, Evelyn Blanchard, is working on getting you all some concrete information regarding the Native American experience and outcomes with mandatory managed care in the past with Salud! in 1997 and CoLTS in 2008. You can reach her at the email above or at the Center at 505-255-2840. I will also be available on my mobile 505-231-1542 from tomorrow evening forward. Please don't hesitate to let me know if there's anything else I can provide you with.

We really appreciate the help and support you all have given to date and may be able to give to this issue moving forward.

Very truly yours,

Quela Robinson