Friday’s Medicaid Council meeting focused on implementation
of last year’s
budget provision that will end coverage for 17,688 HUSKY parents on July 31st
of this year. DSS reported on efforts to assure that people still eligible for
Medicaid in other categories do not lose coverage. Of the 1,215 parents who lost
coverage last year due to the cuts, almost half (47%) were able to continue
coverage in Medicaid. Only one in seven (14%) was able to afford and purchased
coverage through AccessHealthCT, CT’s health insurance exchange. 52 parents
selected an AccessHealthCT plan but cancelled or disenrolled, likely
due to cost. Council members voiced deep concerns about ineffective
notices, and children losing coverage when their parents do. Many children lost
coverage in 2003 when
the state last cut coverage for HUSKY parents even though children’s
eligibility levels did not change. Council members offered to help get out the
message that even if parents lose coverage, children should stay on the
program. The Council asked DSS and AccessHealthCT to come back with a plan for
outreach and assistance for members losing coverage.
Members of the Care Management Committee reported on MQISSP
progress -- the “mighty undertaking” to redesign Medicaid to incorporate
integrated care networks and the potential for shared savings back to those
networks. The committee has been working very hard and very collaboratively to
ensure the program is feasible, but also protects both members and taxpayers.
To have an RFP released this summer, we must finish our work in just a few
weeks. However, two weeks ago a SIM committee dropped a 66-page set of
standards for Community and Clinical Integration Standards for the Medicaid
provider networks, with little opportunity for input. Beyond process concerns
and questions about the evidence-base for the standards and priorities,
concerns were raised that the standards are both extremely prescriptive and
extremely vague in different places. The standards duplicate many successful
programs and collaborations already in place, would place a large burden on
overwhelmed primary care providers, places a large and ill-defined liability on
networks, and would be controlled by SIM which is not
subject to the State Code of Ethics nor does the agency focus on the unique
features of the Medicaid program. In our hastily-scheduled Care Management
Committee meetings to address the issue, members did not have time to fully
outline all our concerns. There is no
funding source for networks even willing to take on this massive mandate.
Advocates have urged policymakers to either delay implementation of CCIP
standards until they can succeed, until other SIM payers require them in their network
contracts, delay the RFP entirely, or make the CCIP standards optional for
networks, as is the case for successful programs in other states.
