• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Nc live 6 8-2010 kohler presentation [compatibility mode]

Nc live 6 8-2010 kohler presentation [compatibility mode]






Total Views
Views on SlideShare
Embed Views



0 Embeds 0

No embeds



Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

    Nc live 6 8-2010 kohler presentation [compatibility mode] Nc live 6 8-2010 kohler presentation [compatibility mode] Presentation Transcript

    • Health Reform Ann Kohler Director of Health Services National Association of State Medicaid Directors American Public Human Services Association June 8, 2010 www.TheNationalCouncil.org
    • Current Status > Legislative Status: g • The House passed the Senate’s version of the bill; • The House passed a package of amendments to the Senate bill through a reconciliation bill; • The Senate passed the reconciliation bill with minor changes; • The House passed the amended reconciliation bill; and • Both of the bills have been signed into law. law > Implementation: • Staggered time-line of effective dates; • Major Medicaid and private-market changes effective 2014; • CMS, NASMD, NGA & State Representatives forming workgroups to address Medicaid Changes. g p g 2 www.TheNationalCouncil.org
    • Key Components of Reform > Medicaid Changes: • Expands Medicaid to everyone under 133% of FPL, with increased Federal funds for this population; • Current eligibility levels, p g y , procedures and methodologies are frozen g until 12/31/2013 for adults and 9/30/2019 for children (including CHIP); • Restructures income calculation for many Medicaid beneficiaries (but y ( not people with Disabilities) to IRS income calculation – Elimination of income disregards; • Elimination of asset/resource test for individuals who have the income calculation restructured; • Mandatory increase to the provider rates Medicaid pays for primary care services (100% Federal funds). funds) www.TheNationalCouncil.org
    • Key Components of Reform > Medicaid (continued): • Expands Medicaid to any individual under 25 previously served through Child Welfare; th h W lf • Creates State-plan option for family planning services; > Other programs: • Includes grants and incentives to expand and subsidize high-risk p pools; ; • Increases funding for ADRCs; • Establishes grants for School-based health services. www.TheNationalCouncil.org
    • Key Components of Reform > Long term Care Long-term Care: • Establishes the CLASS Act: • National long term care insurance program funded by payroll deductions; • Eligibility determined by ADLs, not finances; • C t new options for community-based l Creates ti f it b d long-term care through t th h Medicaid; • Provides FMAP incentives to increase long-term care in the g community; • Provides grants and demonstrations to address IMD coverage. www.TheNationalCouncil.org
    • Key Components of the Bill(s) > Private Insurance Reforms: • “Community Rating – limits on variation in premiums for Community Rating” individuals within a geographic area; • Prohibits exclusion of pre-existing conditions; • “Guaranteed Issue/Renewal” – no one can be denied coverage/dropped due to health conditions; • Removes annual/lifetime limits on care; • Required Benefits Package (Including Rehabilitation, Habilitation, MH treatment). www.TheNationalCouncil.org
    • Key Components of th Bill( ) K C t f the Bill(s) > Individual mandate to buy insurance – allows some individuals to “opt-out” f “ t t” of mandate; d t > Establishment of “Exchange”: • Based on Massachusetts “Connector” model; ; • Provides centralized marketplace to compare insurance and purchase plans; • Federal government provides subsidies for people with low-to-moderate income to assist with the purchase of insurance. insurance > Competition: • Establishes Health care nonprofit cooperatives; • State may offer an insurance plan up to 200% FPL > State Innovation: • Waivers for states to try alternate coverage methods. www.TheNationalCouncil.org
    • Potential Impact to State Programs > Potential Issues: • Eliminating income disregards; • Increased costs on state budgets due to mandatory Medicaid expansions & costs associated with developing and operating the exchanges; • Changes to eligibility systems & interoperability with the exchanges; • Loss of revenue through restructuring of drug rebate programs; • Reduction in “DSH”; • Large expansion may cause access issues for everybody (not just Medicaid recipients). www.TheNationalCouncil.org
    • Potential Impact to State Programs > Potential Positive Changes: • Greater availability of insurance in the private sector; • Broader range of services available through private insurance plans; • N preexisting condition exclusion, denial of coverage or No i ti diti l i d i l f termination of coverage; • CLASS act – LTC without Medicaid funding; g; • New Medicaid coverage for low-income people – including individuals currently served in some State-only programs. www.TheNationalCouncil.org
    • Future Considerations > State Budget issues: • 48 states experiencing budget shortfalls; • Increased Federal Funds (FMAP) expire 1/1/2011; • Bills containing extensions to FMAP increase have passed both the g Senate & House, but have not been reconciled; • Loss of FMAP would lead to significant rate cuts & service reductions. reductions For more information on proposed cuts: http://www.aphsa.org/Home/Doc/WhitePaperFMAP.pdf www.TheNationalCouncil.org
    • For More Information: Ann Kohler, Director of Health Services National Association of S N i lA i i f State M di id Di Medicaid Directors American Public Human Services Association Ann.Kohler@aphsa.org 202.682.0100 Ext. 299 www.TheNationalCouncil.org
    • Use telephone or computer speakers > Call 888.259.8414 for technical support pp www.TheNationalCouncil.org
    • Webinar Recordings/Presentations g Available 48 hours AFTER the live event at www.TheNationalCouncil.org (Click on Resources & Services and then on National Council Webinars and Recordings and Presentations) 13 www.TheNationalCouncil.org
    • National Council Membership > Are you making the most of your National Council membership? www.TheNationalCouncil.org/cs/member_be nefits > Not yet a member? Join today! Email Membership@thenationalcouncil.org or call 202.684.7472 14 www.TheNationalCouncil.org
    • Mental Health First Aid Instructor g Trainings > Blue Bell, PA May 3-7 > Denver, CO May 10-14 > Washington, DC W hi t June 28 J l 2 J 28-July > Houston, TX July 12-16 > Chicago, Chicago IL August 2-6 > San Francisco, CA September 13-17 > Atlanta, GA , September 27 - October 1 p Apply at www.MentalHealthFirstAid.org 15 www.TheNationalCouncil.org
    • www.TheNationalCouncil.org
    • National Council JOBank > Recruit top-notch mental health and addictions executive, administrative, policy, clinical, d i i t ti li li i l and direct care staff > P t openings and b Post i d browse j bjobs www.TheNationalCouncil.org
    • National Council E-Learning > 400+ courses for CE credits > Special price for organizations with 60 or fewer employees p y > Helping you meet compliance, licensing, and insurance requirements Partnership with Essential Learning www.TheNationalCouncil.org
    • www.TheNationalCouncil.org
    • > April 21: Geoffrey Canada on Weaving a Community Safety Net > April 27: National Council Client Engagement and Retention Best Practice Findings > May 18 Cli i l Feedback Tool 18: Clinical db k l www.TheNationalCouncil.org