Centennial Care Brochures Medicaid Coalition discussion

Dear Medicaid Coalition members,

 

   As many or most of you have learned, the federal Medicaid/Medicare agency (CMS) has formally approved the state's Centennial Care waiver proposal.  The approval was made on July 12, and HSD put out a press release yesterday.  There is a small article in the Metro section of today's ABQ JOURNAL, which mostly highlights the new co-pays.

 

   CMS attached a large number of special Terms and Conditions to its approval.  The 97-page document containing them has been posted to the HSD web site (click on the "New Mexico Centennial Care" button), and has lots of important information that will be of interest to individual constituencies as well as advocates and beneficiaries generally.  In addition to making sure you are aware of this document, I wanted to mention just two of the Ts&Cs here:

 

      1.  HSD is required --- in collaboration with the MCOs --- to conduct educational events throughout the state to provide current and potential enrollees with information about Centennial Care and its MCOs.  There will be separate events for beneficiaries and providers, with the beneficiary events being focused on the various beneficiary populations (i.e., families, Native Americans, elderly, HCBS, etc.).  The requirement is discussed at page 43 of the document.  I mention it here because HSD is required to conduct the events "within" the five month period before Centennial Care starts, meaning the period starts in just over two weeks.  Of course "within" is an ambiguous term, but the reference to a five-month period has to mean something.

 

      2.  HSD is required to create and maintain an "Independent Consumer Support System" to assist beneficiaries with understanding coverage and resolving problems.  The requirement is discussed at pp. 31-32 of the document.  HSD is required to submit a plan for this office/program to CMS (for CMS' approval) within 60 days after approval of the waiver, which probably means on or about September 10.  I would appreciate those in the know clarifying whether this is something new, or already envisioned by contracts and/or funding on which some of you are already working.

 

   As a final note, I should say that while the Ts&cs document definitely is chock full of important pieces of information, it does not include many specifics regarding MCO obligations that were alluded to in the original procurement documents and are presumably articulated in the MCOs' contracts.

 

Mike

Hi All – I’m working on ILRC’s newsletter and am hoping to put something in about Centennial Care.  Since I wasn’t aware of anyone getting an explanation on the discrepancies between the information in the brochure and what HSD staff have been announcing at public meetings, I made a couple of calls today to see what they would tell me.

 

First I called the number listed in the brochure ‘for more info.’  Long hold time, then a woman answers “Xerox.”  Of course, I know through my work that the state has expanded their contract with Xerox to include fielding calls on their information line, but I expected they would at least answer by saying “Human Services Dept.”  Anyone who is not already in the Medicaid system but is calling for information will think they dialed the wrong number when they are greeted that way.

 

The Xerox woman told me she doesn’t have information about Centennial Care – they haven’t received that training yet. This is what she can do:  if I am a provider and need information about a specific Medicaid client, she can check on claims status or eligibility; if I am a Medicaid recipient, she can issue a new card.  For information about Centennial Care, she directed me to the HSD website.  When  I told her I needed to speak with a person, she gave me a number which turned out to be an Income Support Division office. 

 

Then I got a number for Matt Kenicott from the website (you probably know he is HSD’s Communications Director).  I asked him about the conflicting information on application dates for new eligibles.  Matt said HSD can accept applications starting October 1^st, but benefits won’t begin for new enrollees until after the beginning of January, so there wouldn’t be any point in applying before January 1^st.  I said that if someone is in need of medical attention and wants to get in to see a doctor on January 1^st, they would want to apply as early as possible.  He said his understanding is that even if eligibility is not confirmed till later in January, it would be retroactive to January 1^st.  We got into a complicated conversation about what happens if the person pays out of pocket, and in the end, he suggested that I speak with Kathy Slater-Huff  in Medicaid (827-3100).   Matt said training on Centennial Care is underway, but he isn’t sure where Xerox is in that process.

 

I will be calling Kathy tomorrow (Thursday).  If anyone wants to join me on that call or has other questions I should be asking, please email me or call 934-2042.

 

Thanks –

 

Carla Baron