Tribal opt-in for managed care
Most of New Mexico’s Indians will not be required to receive Medicaid benefits through a managed-care organization, despite state Human Services Department efforts to bring all beneficiaries under its proposed Centennial Care approach to Medicaid.
In a letter to HSD, the federal Centers for Medicare and Medicaid Services, which must approve state Medicaid programs, told the state that Centennial Care should allow Native Americans to “have the opportunity to voluntarily opt-in to managed care.”
The letter, signed by Cindy Mann, director of the Center for Medicaid and CHIP Services, said the state’s application to establish Centennial Care could include programs to “promote and encourage voluntary enrollment, but there will be no expansion of mandatory managed-care enrollment for Native Americans.”
Indians who now receive managed long-term care services, including those eligible for both Medicare and Medicaid benefits, can continue, she wrote.
Several New Mexico tribes and Indian health administrators and care providers objected to including all Native Americans in managed-care programs. They said care would suffer, costs would rise and tribes’ efforts to create their own health systems would be impeded.
Some tribal officials said the state violated tribal sovereignty by ignoring requirements to consult with tribes and, instead, merely told them of the plan.
CMS officials met at least twice in New Mexico with Indian leaders to discuss their concerns over the winter.
Mann wrote that her letter was intended “to memorialize the work we have accomplished together” to implement Centennial Care.
“We have made significant progress in developing terms for a demonstration that will enable the state to assure Medicaid beneficiaries access to a fully integrated, coordinated service delivery system,” Mann wrote. “We particularly appreciate the focus on care coordination as a means to assuring the delivery of the right care at the right time and in the right settings.”
HSD has estimated the changes it intends to make through Centennial Care will save $453 million over five years. It intends to launch it Jan. 1 and has chosen four managed care companies to serve beneficiaries.
Mann’s letter did not approve Centennial Care but identified issues HSD must address to gain approval.
— This article appeared on page B1 of the Albuquerque Journal
In a letter to HSD, the federal Centers for Medicare and Medicaid Services, which must approve state Medicaid programs, told the state that Centennial Care should allow Native Americans to “have the opportunity to voluntarily opt-in to managed care.”
The letter, signed by Cindy Mann, director of the Center for Medicaid and CHIP Services, said the state’s application to establish Centennial Care could include programs to “promote and encourage voluntary enrollment, but there will be no expansion of mandatory managed-care enrollment for Native Americans.”
Indians who now receive managed long-term care services, including those eligible for both Medicare and Medicaid benefits, can continue, she wrote.
Several New Mexico tribes and Indian health administrators and care providers objected to including all Native Americans in managed-care programs. They said care would suffer, costs would rise and tribes’ efforts to create their own health systems would be impeded.
Some tribal officials said the state violated tribal sovereignty by ignoring requirements to consult with tribes and, instead, merely told them of the plan.
CMS officials met at least twice in New Mexico with Indian leaders to discuss their concerns over the winter.
Mann wrote that her letter was intended “to memorialize the work we have accomplished together” to implement Centennial Care.
“We have made significant progress in developing terms for a demonstration that will enable the state to assure Medicaid beneficiaries access to a fully integrated, coordinated service delivery system,” Mann wrote. “We particularly appreciate the focus on care coordination as a means to assuring the delivery of the right care at the right time and in the right settings.”
HSD has estimated the changes it intends to make through Centennial Care will save $453 million over five years. It intends to launch it Jan. 1 and has chosen four managed care companies to serve beneficiaries.
Mann’s letter did not approve Centennial Care but identified issues HSD must address to gain approval.
— This article appeared on page B1 of the Albuquerque Journal
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