New Medicaid vendor chosen for non-emergency medical transportation

The State of Idaho has chosen a contractor from among four bidders to handle the non-emergency medical transportation needs of Medicaid patients.

Medical Transportation Management, Inc. (MTM) will take over the program March 6, 2018. The existing contractor, Veyo, exercised an early-out provision in its $70 million, three-year contract, citing expensive, unexpected restrictions on its business model that uses independent drivers.

“The Department of Health and Welfare will work with the existing broker, MTM and stakeholders to ensure a smooth transition for our Idaho Medicaid participants and providers,” said Matt Wimmer, administrator of Health and Welfare’s Division of Medicaid.  Continue reading

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Idaho Health Care Plan information sessions set Thursday, Dec. 7 in Pocatello and Monday, Dec. 11 in Coeur d’Alene

Informational, question-and-answer sessions are planned for Pocatello on Dec. 7 and Coeur d’Alene Dec. 11 to discuss the Idaho Health Care Plan, aimed at delivering better health care for Idahoans. Continue reading

Supported Living Rates Set Following Comprehensive Survey

Changes to Medicaid’s supported living rates are being finalized following the completion of an intensive cost survey of Idaho providers.  This benefit pays for caregivers to support developmentally disabled adults in their own residence rather than in an institution or in a certified family home.

A group of supported living providers had previously sued the Department of Health and Welfare, contending that rates were too low to support their services.  The 9th Circuit Court enjoined the department to pay a higher rate for these services.  The Office of the Attorney General contested this case up to the United States Supreme Court, which resulted in the landmark Armstrong vs. Exceptional Child Center decision last December that established that providers do not have standing to sue states to increase their reimbursement. Continue reading

DHW committed to helping people live independently

The federal district court recently ruled on a lawsuit involving people with developmental disabilities who receive Medicaid funding to pay for their day-to-day living support. Medicaid’s goal is to provide people with disabilities the supports they need to live as safely and independently as possible in their community, rather than an institution.

Medicaid will pay for up to 15 services directly related to a participant’s developmental disability as well as any services for additional medical needs they may have. Developmental disability services can include such things as 24 hour care so that participants can live in their own home, therapy to help participants develop skills they need to live in the community, non-medical transportation so that they can access and integrate into the community, and other supports that ensure that their homes meet their functional needs. Continue reading

Medicaid survey of supported living services providers will begin in mid-February

Medicaid’s cost survey of providers for supported living services will begin soon. This survey is for providers who offer up to 24-hour support to qualified participants with developmental disabilities so they can live in their communities rather than in an institution.

We have received a number of questions about the survey and how it will be conducted. The framework of the study is set by Idaho state regulations, which you can find here (page 27, section 037).  Continue reading

Idaho Medicaid to conduct cost survey with providers of supported living services

Idaho Medicaid announced today that it will work with providers to conduct a cost survey to evaluate the rates paid to providers of supported living services. During the survey period, Medicaid will pay temporary rates that will go into effect Feb. 1.

These changes do not affect all Medicaid providers, only those who provide community-based supported living services to qualified participants with developmental disabilities.

Supported Living services allow adults with developmental disabilities who choose to live in their own homes up to 24-hour support for personal care, supervision, and to receive help building skills needed to become more independent.

Medicaid had originally announced reinstatement of an approved rate schedule after a U.S. Supreme Court ruling in 2015 that upheld the state’s ability to set reimbursement rates for Medicaid services. Service providers objected and said those rates would be too low, with several suggesting they would no longer participate in the program.  Continue reading