Medicaid Council meeting update

Friday’s Medicaid Assistance Program Oversight Council meeting was very productive and mainly positive. The main area of discussion was DSS’ implementation of new asset limits required by budget negotiations (bad news) and new spend down tracking processes (good news). This August the enrollment brokers (Xerox, formerly ACS) will handle tracking and evaluation of medical bills as well as information and support for people “spending down” to Medicaid eligibility. This has been a significant barrier to coverage for up to 17,000 people at any time. The new process will move time-consuming documentation to ACS and to electronic formats, providing welcome relief for both frustrated consumers and overwhelmed DSS workers. In bad news, as an outgrowth of negotiated budget cuts, DSS is applying to CMS for a waiver to the LIA program (formerly SAGA) to institute a $10,000 asset test (exempting a home and one car), permission to count parental income and assets for applicants under age 26 who live with parents or are claimed as dependents, and to establish a 90 day limit on nursing home coverage. Spending down to LIA coverage will not be necessary in January 2014 under national health reform. DSS expects that many or most of those with assets will be able to transition to Charter Oak coverage for the interim, which their assets should cover. DSS will also assist anyone needing more than 90 days of nursing home care to apply for disability or other Medicaid coverage. In other news, DSS responded to comments on their dual eligible application and “reserved” the requirement for a behavioral health co-lead in each neighborhood to allow further study and agreed to include incentives in all three years of the pilot for health neighborhoods that improve performance and outcomes, less than if they also achieve savings, but something. DSS also outlined ConnectCT, their plans to improve application, web, customer service and document management/workflow processes. Long overdue and very exciting; hoping for more meetings like this.