From the Center on Law and Poverty
Hello, Everyone,
Hope all of you had a safe, warm welcome to the New Year.
The message below indicates that the Managed Care Organizations who will be awarded contracts to manage the Medicaid program will be identified by the Human Services Division (HSD) during the last week of this month. After selection the MCOs awarded contracts will spend the next twelve months establishing their readiness to implement the contract. That means in the next twelve months the kinds and manner of services your people will receive will be designed and determined by the MCO. The twelve month period is an opportune time for tribes to come together to define conditions and services that are deemed appropriate for their people. For example, accessibility to care must be guaranteed by the MCO. As the newspaper article about the Medicaid program in Connecticut demonstrates MCO contract practices do not guarantee primary care accessibility. Many of you have heard about the experience of people from Ramah who were assigned primary care providers in Farmington. If an MCO cannot guarantee real accessibility, the people from your tribes can refuse to enroll with that organization. If the tribes do not step up do this work, the MCOs will determine the kinds and methods of services that the people will receive. The ability and strength to influence the design of services and the methods by which they will be delivered will in large part be determined by tribal officials and health department staff, in other words, you.
This work needs to occur at the same time that the tribes are taking a stand on the matters contained in Governor Madalena’s letter to the other Governors. At the Medicaid convening tribal officials acknowledged the necessity of an informed health care staff to advise them about issues and courses of action to take in relation to them. The old adage, together we stand, divided we fall, is clearly appropriate here. I will ask Eric Lujan who has the role of primary convener of both what is called the Kewa group and the National Indian Council on Aging Health Committee to call for a meeting to develop a response to contract design. It might be most useful if there were localized meetings of tribes to consider the Centennial Care plan and what would be determined as sufficient response from the MCO contractor as the initial step. Following this work the tribes could meet together to finalize unified requirements for contractors that are supported by all them. When these decisions have been made, then tribes would proceed to contract with one MCO or another. These suggestions that I am making to you are based on my eighteen-year experience working with the Northwest tribes of Idaho, Oregon and Washington in their negotiations with their respective states. You are stronger than is generally recognized, don’t cede your strength.
Best regards,
Evelyn
New Mexico Human Services Department Selects Finalists for Centennial Care
The New Mexico Human Services Department has selected finalists for the Medicaid Centennial Care Request for Proposal (RFP) and is moving forward with contract negotiations. However, since this process is still in an open procurement, the names of the selected finalists will remain confidential until the approval of contracts, which is anticipated to occur between January 26 and February 1, 2013. Once the contracts are approved the Centennial Care organizations will begin a readiness year through December 2013 with implementation to begin January 1, 2014.
Sincerely,
Betina
Betina Gonzales McCracken
HSD Project Manager and Public Records Custodian
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