discussion post HB 376 passing House Health Government Indian Affairs Committee

 

Ken was able to meet with Congressman Ben Ray Lujan's staff this afternoon and they reiterated what Regis shared with us this morning. However when Ken asked what issues the State needed to address before CMS would approve Centennial Care, they did not provide specifics. 

 

That said, what specific outstanding issues has the State or CMS not answered adequately, if at all? Please be as specific as possible so that way we can submit those issues back to the Congressional delegation because They want to submit those issues for answer from CMS. 

 

Also, please try and get those issues back to me as soon as possible.  

 

Well done today everyone! 

 

 

 

 

After the last consultation there were many questions I'm sure April, Maria, and Anthony have some very specific questions that have not been answered adequately.

 

As for the NMICoA Health Committee and myself,

 

The reasoning for mandating the auto enrollment of NA population into Managed care, they say because they "feel that the State through the MCO can do a better job"  What proof/data do they have that supports this claim? Where is the fiscal data that says that including the NA population will be more cost effective for the state versus the 100% FMAP for tribal programs?

 

Tribal selection of Oversight boards for MCO? they never agreed or disclosed how the selection process will be determined. 

 

What are the plan for outreach and education? will HSD do this or will they rely on MCO to do this?

 

Have they considered a separate waiver for NA population? or Money follows the Person? 

 

just some quick considerations

 

Erik

 

 

 

 

 

 

 

Here’s HSD’s argument re: HCBS and managed care

The central component of Centennial Care is a comprehensive care coordination model that

integrates and addresses each member's physical health, behavioral health, social and long-term

care needs across the full continuum of services and settings. This kind of comprehensive care

coordination program is not available in Medicaid’s fee-for-service model. Additionally, the

Centennial Care program expands access to the home- and community-based services (HCBS)

benefit to all otherwise eligible Medicaid enrollees who meet a nursing facility level of care. In

the current Medicaid program, only persons occupying a waiver slot get access to the full HCBS

package. Access to HCBS is restricted to Centennial Care recipients and not available in the fee-for-

service program.