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 “Idaho Health Care Plan information sessions set Thursday, Dec. 7 in Pocatello and Monday, Dec. 11 in Coeur d’Alene”
Veyo, LLC has terminated its contract with the Idaho Department of Health and Welfare to provide Non-Emergency Medical Transportation Services (NEMT) for Medicaid beneficiaries in Idaho, effective March 5, 2018. Continue reading “Medicaid non-emergency medical transportation provider terminates contract with state of Idaho”
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 “Supported Living Rates Set Following Comprehensive Survey”
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 “DHW committed to helping people live independently”
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 “Medicaid survey of supported living services providers will begin in mid-February”
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 “Idaho Medicaid to conduct cost survey with providers of supported living services”
Administrators for Medicaid, Mental Health Services and Healthcare Policy Initiatives presented the governor’s budget recommendations this morning before the Joint Finance and Appropriations Committee. Links to their slides are below:
The Idaho Medicaid program will delay a rate adjustment for supported living services from January to February 2016 to allow providers more time to adjust to the change and provide accurate information to participants about service options. The state had told providers last week that the rate adjustment would occur in January but realized more time would be necessary for many of them.
The rate adjustment is the result of a U.S. Supreme Court ruling in April of this year that upheld the state’s ability to set reimbursement rates for Medicaid services. A specific group of Medicaid providers had filed suit against Idaho in 2011 to force the state to pay higher rates. During the three years it took the lawsuit to work its way through the courts, the state paid providers the higher, court-ordered rates. With the Supreme Court victory, Idaho will reinstate the previous rates for Medicaid supported living services beginning February 1. Continue reading “Idaho Medicaid delays rate adjustment for a month”
For a person enrolled in both Medicaid and Medicare, navigating those systems simultaneously can be a nightmare. But that is changing. Idaho Medicaid is learning from other states and implementing innovative solutions to better coordinate benefits and manage costs for people in those programs.
People who are eligible for benefits in both programs typically have more than four times the healthcare expenses than Medicare-only beneficiaries. They also have a higher prevalence of complex and chronic health conditions than the general population and must navigate two benefit systems that were not designed to work together.
Idaho Medicaid is proud to offer a coordinated health plan for most Idaho residents who are eligible and enrolled in Medicare Part A and B and full Medicaid coverage. This program, the Medicare-Medicaid Coordinated Plan (MMCP), offers one set of comprehensive benefits, one accountable entity to coordinate the navigation and delivery of services, and one care management team to develop care plans and coordinate benefits. Continue reading “Innovative health plan coordinates Medicare and Medicaid services”