Last Day of Legislative Session

Good Morning Everyone,

From the looks of the Senate floor schedule it doesn't look like House Bill 376 is going to be heard in this morning.  I do not have any further details on it's status. From what I have been told House bill 376 never made it out of the Senate Finance Committee.  It was being held up, because Senator John Author Smith's aid Mike Burkhardt didn't understand/like the ability for NA to switch between Managed Care and Fee for Service on a monthly basis.  We were not given the chance to challenge, debate, or present an amendment, the bill was simply not heard therefore tabled.  I am new to the whole legislative process,  I think that we could have lived without this provision or amended it so that NA were given a period of 30 days after becoming eligibility was determined enrollment was completed, to switch between the 2 options. After that 30 day period is over then that NA would be locked into that option for one years time.  This is how enrollment currently works with the Salud program.  I believe that the issue was that HSD thought that allow NA to do this would put a burden on HSD administrative staff and increase administrative costs. The other issue with this ability is HSD believed that allowing NA to switch would have a negative affect on MCOs ability to coordinate care.  

Both of these statements are unsubstantiated, there is no evidence that NA currently switch between Managed Care or Fee for Services on a regular basis, 80-85% of NA population continues to remain "opted out" of Managed Care. Care Coordination for those NA individuals who opt out may not happen at a MCO but, as Tribal Health programs have stated, does happen at the Health Clinic level, by Health Benefits coordinators, CHR and Clinical Staff.

HSD has also stated that they do not have a "Fee For Services" Program they do have the ability to reimburse for Medicaid Services provided by Medicaid Providers, and that this program is too costly, because they do not have the ability to Track cost vs. Health outcomes. I don't think that HSD understands the Argument where they might not have the ability to track health outcomes or coordinate care through the Fee For Service Provision of Medicaid, but Tribes Do, and Do well.  This it seems less about providing healthcare services and more about Control, control of policy, control of services, control of eligibility, and Control on Funding. 

I will keep you all informed if there are any changes, the conflict with HSD and MAD over Centennial Care and its mandates for NA doesn't end here.