Tag: budget

UPDATED: Your rights in the PASSE

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We have been asked to update this post for clarity. These are your rights, but we don’t want anyone to lose services. So please see the updates below.

The PASSE system has been going for almost 45 days now. We don’t have many more days of the “transition plan” where our plans are supposedly covered as they were before the PASSE took over. Doctors are saying they won’t join, and some providers are saying they haven’t gotten paid. Some people were put into the PASSE system, and they want out. They’re being told that they can’t get out, but there are things people can do.

You have rights!

(1) There is a lawsuit you can join.

If you feel you’ve been wronged by the PASSE system, contact Thomas Nichols at Disability Rights (tnichols@disabilityrightsar.org). He will want to know specifically how you’ve been wronged:

  • have you ever had to pay out of pocket for a service?
  • have you lost providers and have no other choices in your area?
  • has the PASSE denied to pay for a medicine or forced a new co-pay?
  • has the PASSE denied a service you were getting?
  • have you tried and tried to contact your care coordinator with no response?
  • is your PASSE unreachable? have they returned your calls?

(2) You can opt out of the PASSE. (BUT)

If you call to opt out of the PASSE, you will lose access to the services that only the PASSE program provides.
– You will lose your Waiver slot if you are a person with the DDS Waiver or Wait list. This should be a careful decision because a lot of people have waited a long time for these services.
– If you get BH services, you will not be able to get those higher level services you might need.

Yes, there are ways you can opt out of the PASSE. BUT you need to be careful and protect yourself. Dropping out may solve a problem for you now, but it may cause you a problem later. Make sure you ask all of the right questions (see below). You might still be able to get what they call “State Plan Services,” but you won’t be able to get the “Community & Employment Supports Waiver” or the “Arkansas Community Independence Waiver.” Depending on how you qualify for Medicaid, you might not get any services at all.

DD

If you’re with the Developmental Disability side, that means you are giving up your waiver slot. You might be giving up some services you might need. Also, the way you qualify for the DD Waiver is different than other Medicaid, so you may not qualify for any services. Some people have waited a super long time for services, and we just don’t want you to do anything that hurts more in the long run.

Programs like ARKids and TEFRA are only for “kids.” For example, if you are on TEFRA right now, you could choose to drop your waiver waiting list slot and go back to TEFRA. Please remember that TEFRA only lasts until you’re 19. The service options are limited for adults, so make sure you will have coverage if you drop your waiver slot.

If your plan is to drop out and come back to the Waiver, just know that you do have to start all over again.

BH

If you’re with the Behavioral Health (mental health) side, you can go back to Tier 1 services, but there may be some services you can’t get now. So if you are a child who was with ARKids, but then because of a BH assessment were put into a PASSE, you could go back to ARKids. The way you do this is by not getting your next reassessment. You have to be assessed to be in a PASSE, so if you turn down your next Independent Assessment when Optum calls, they won’t put you in a PASSE.

Questions to ask:

  1. What services will I lose if I opt out of the PASSE?
  2. Which Medicaid program will I qualify for if I opt out of the PASSE?
  3. Can I still go to {name the provider} if I drop out of the PASSE?

If you want to drop out of the PASSE, you need to call the PASSE Ombudsman. They can send you the right direction. 1-844-843-7351

*Remember, if you are on the BH side, you might have to wait until you can refuse your next Independent Assessment.

(3) You can turn down an Independent Assessment.

Everyone in the PASSE is supposed to have gotten an Independent Assessment. If you refuse a re-assessment, you will be dropped from the PASSE program. If you are on the DD Waiver, that means you will lose your spot.

Before you get put into a PASSE, you have to get an Independent Assessment. This company named Optum calls and sets up an appointment. You can turn this down. They may tell you that you have to do it, or you could lose services. You do not have to do it. This is your choice.

Not getting an Independent Assessment for DD or BH does mean that you can’t be in the PASSE system. So look at #2, and make sure you are making the best choice for you.

(4) You can call your legislators.

Call your legislators. They voted this in, and they need to hear if something is affecting you negatively. They represent us, and we need to let them know what’s going on.

Here’s how! Visit:http://www.arkleg.state.ar.us/assembly/2019/2019R/Pages/LegislatorSearchResults.aspx?member=&committee=All&chamber=

Click their name, and it will take you to their contact info.

(5) Switch your PASSE during Open Enrollment in May.

May 1-31 is Open Enrollment time for the PASSE, and that means you can switch to a different PASSE if you want to. If you like your PASSE, you can keep your PASSE. If you want to switch, call 1-833-402-0672. Watch the PASSE networks closely for changes before you switch.

Tax Reform Bill: How to Contact AR Senators

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Watch the video above to get all of the contact information to get contact information and tips.

Other helpful links:

https://www.npr.org/templates/event/embeddedVideo.php?storyId=567758536&mediaId=567762951

Understanding the House Tax Bill

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Taxes affect our daily lives, and the House is working on a bill to “reform the tax code.” If taxes are drastically altered, it won’t just affect our personal taxes; Medicaid funding could be affected as well. For example, Senator Cotton called for the repeal of the Obamacare individual mandate through tax reform. That’s why it’s so important to stay on top of what’s happening.

A House committee released the bill, the “Tax Cuts and Jobs Act,” this afternoon, and it’s a very long read. 

This is just a first version. They will revise the bill and try to pass it through the House by Thanksgiving to send to the Senate in order for it to take affect by January 1, 2018. 

Take the time to try to understand it and respond if necessary. Here are a few articles to help you understand what’s going on:

Make sure you understand this for yourself, and contact your U.S. Senators with your questions, concerns, and comments!

    Solution to Denied PAs for Therapy Providers

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    MSL has been made aware that there’s a lot of confusion on submitting PAs to request more than 90 minutes of therapy for children since the therapy cap was implemented on July 1, 2017. Lainey has talked with AFMC and DHS as well as the OT Association President who has been successful in submissions.


    You need a separate statement letter that answers the following questions individual to the child’s case:

    1. How does the therapy administered effectively treat the beneficiary’s condition?

    2. What gives you a reasonable expectation that the beneficiary is experiencing meaningful improvement or that the therapy is preventing worsening of the beneficiary’s current condition?

    3. How are the frequency, intensity, and duration of the requested therapy services realistic for the age of the child?

    List the question and provide the answer. Make sure you provide the other information listed there as well. AFMC told Lainey today that they will deny any submission that does not have this requirement. If you have received denial with 3 statements that say you didn’t meet the requirement, try resubmitting with this.






    Friends Don’t Let Friends Go Without Health Care

    Published on by medicaidsaveslivesLeave a comment

    Author: Lainey Morrow, MSL Founder & parent

    IMG_0382

    We’re all struggling, aren’t we? We can’t very well handle someone else’s bills probably, but there are fairly easy things we can do. One very sad thing I frequently encounter is the suffering of individuals when great resources exist to prevent such a thing. Sometimes it might be a person whose health is suffering, while for others it may be a suffering future due to delays in development.

    As a matter of fact, I have experienced this myself. For 2 years, my husband and I struggled to provide for my daughter. We went into debt, staying awake many nights with worry, and she went without necessary services. We thought we were on our own. We thought we’d been denied for the only things that were out there. We worked as hard as we could, and still it wasn’t enough.

    By the time she was 2, my daughter was very developmentally delayed. We didn’t find out about resources we could have accessed until we moved to another state. My friend told me about TEFRA, and my daughter was easily accepted. It makes me sick to think of all she went without simply because we didn’t know this immense resource was available to us. All I needed was someone to tell me about it, which is why that’s a huge mission of MSL – to pass along important information and to connect people with great resources that exist out there.

    Someone from another state recently asked me what resources exist for them, so I started to look into it. What if you don’t qualify for Medicaid? TEFRA is an option that only certain states provide, but how do you know if it’s available in your state? If TEFRA isn’t available or you don’t qualify, then what?

    Let no one go without, so here’s all my research for you to share.

    Do you qualify for Medicaid?

    Ways to qualify for Medicaid.

    Where to start if denied.

    Which states have TEFRA? (This is a specific type of Medicaid usually for kids with disabilities under 19, usually requiring families who make too much to pay a premium.)

    If your state doesn’t have TEFRA or you don’t qualify, what are the other options:

     

    Like I said, I didn’t find out about something my daughter desperately needed until another parent told me about it. Two long years, and we could have gone more.

    We can’t help everyone, but we can help someone. Someone helped me. Keep your eyes open. You may not need a resource, but someone in your friends list might. If you see a good resource, share it! It just takes a few clicks. Charities are out there to be used. They want to help people who truly need help. Sometimes they just need a little free publicity to connect with the people who need them.

    This is just a start. If you know of any great resources, especially ones that apply to all states, please send them to me to share!

     

    Senate pulls All-night Session to Vote on Skinny Repeal

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    The Senate is set to vote on a newly written bill, referred to as the skinny repeal, barely released an hour ago. They will vote around midnight.

    Read the full text.

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    Even Senators dislike it, but they may still vote it through.
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    Watch live as they vote:
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    Track the votes.

    Senate Voted to Proceed: Now What?

    Published on by medicaidsaveslivesLeave a comment

    Earlier today, the Senate voted 51-50 to proceed with debate over the health care bill. With only 2 opposing Republican votes, just 1 shy of what was needed, plus a tie-breaking vote from VP Pence, the motion succeeded. We now move toward serious Medicaid cuts that can’t be reversed once set into motion, and it will take all of us standing together to prevent it.

    Watch how each Senator voted.

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    Data shows that any bill, amendment, or revision proposed so far will be detrimental to Medicaid recipients. We (MSL) oppose the per capita caps or block grants that have been proposed because they will shift great stress to state budgets and reduce the ability to give recipients the coverage they need. We oppose ending expansion because it will result in millions losing coverage. In addition, the aforementioned bills remove essential health benefits and pre-existing condition protections, which would be detrimental to all Americans, making coverage unaffordable if not unattainable for many.

    As part of the AACF statement on how this vote will affect Arkansas, Arkansas Advocates for Children and Families said: “Today’s vote shows that we have more work to do. Despite an outcry from health care professionals, business owners, families, and even governors, many Senators have decided to move forward with legislation that will destabilize the entire health care system. Too much is at risk to continue down the current path. Children with special needs, elderly enrollees, and people with chronic conditions who rely on Medicaid will lose coverage. Health care for families that were able to purchase affordable coverage, many for the first time, is also at risk.

    The people have spoken—any proposal that falls short of guaranteeing everyone affordable, comprehensive coverage, is unacceptable. Now, it’s time for Congress to listen. We ask that Senator Cotton and Senator Boozman commit to voting no on any bill that endangers the health of tens of thousands of Arkansans. Anything less is breaking their promise to all of us.”

    Now that we understand the ramifications haven’t changed, here’s what will happen next:

    1. The Senate will debate for 20 hours. By rules, to be fair, Republicans and Democrats get equal time of 10 hours each.
    2. The Senate will probably vote a bunch of times on amendments and such.
    3. Then the Senate will vote on a finalized bill and send it to the House.
    4. The House will vote, and if it passes, they’ll send it to President Trump.

    See a flow chart.

    As you can see, if you oppose Medicaid cuts, you can’t give up. Not a single Democrat voted to proceed, and we only need a few Republicans to oppose to keep any bill from moving forward. We were only one opposing vote short. Take a breath, renew your determination, and communicate in any way you possibly can!

    Contact your Senator!

    Email your Senators’ legislative aids!

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    Stand strong!

    Take Action: Graphic to Share

    Published on by medicaidsaveslivesLeave a comment

    The news changes like the wind. Are they voting or aren’t they? Repeal and replace or repeal without replace? No matter what’s happening with them, we need to continue to make our needs and wants abundantly clear.

    Many are saying that they can’t get through to Senators via phone calls. Don’t stop calling because they are counting the calls. 866-426-2631

    However, social media is a great way to publicly contact your Senators, especially since they won’t post their direct email addresses.

    Share this graphic with them and tag them in your posts. Use hash tags like #BCRA or #ProtectOurCare to help others see your posts!

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    Making Sense of the Manuals for Public Comment

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    Screen Shot 2017-07-17 at 10.36.45 AMDHS released several manuals to the Medicaid website on July 13, 2017 that are available for public comment until August 11. Once public comment ends, these rules will be sent through the legislative committees and passed as law.

    “In accordance with federal and state law, the Division of Medical Services of the Arkansas Department of Human Services must advertise and make available for public comment proposed new and amended rules and other documents, such as certain initial waiver requests and waiver renewals.”

    However, they released over 60 documents actually, which may have left you feeling confused about which one needs your comment or what’s in them all. Here’s your guide to wading through the state terminology and legalese.

    RULE #1: When you send in your comments, make sure to list the document that you wish to comment on!

    RULE #2: Make sure you send your comments to the appropriate person.

    Send your comments to Shelby.Maldonado@dhs.arkansas.gov, and as long as you’ve included the right document title, she will be able to direct it to the correct person.

    • If you’re viewing this on a phone or tablet, you might want to turn it to the side (landscape) to view the width of the table well. The right 2 columns are what MSL has added to help with the list that DHS provided.

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    Instead of scrolling through the long table, which can be confusing, this list of topics can get you straight to what you want to see. Click the link to go directly to the corresponding manual in the table.

     

    The following table will attempt to explain what each document is (memo, explanation letter, mark up with changes, or new manual), what it contains, and possibly some documents to assist you. Remember, the list of topics above can assist you in finding what you need much faster.

    Document Title Document Description Assisting docs/info
    Interested Persons and Providers Letter for DDS Standards for Certification, Investigation and Monitoring; State Plan Amendment 2017-011; Child Health Management Services provider manual update; and Developmental Day Treatment Clinic Services provider manual update IPLtrSPA17-011.doc memo
    (SPA011 – 1 of 15)
    State Plan Amendment 2017-011 Attachment 3.1A 1i SPA17-011-31A1i.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
    SERVICES PROVIDED, CATEGORICALLY NEEDY (page as it will appear in new manual)
    (SPA011 – 2 of 15) Page 1i
    State Plan Amendment 2017-011 Attachment 3.1A 1i with tracked changes SPA17-011-31A1i-markup.doc SAME MANUAL PAGE: mark up that shows changes
    (SPA011 – 3 of 15) Page 1i
    State Plan Amendment 2017-011 Attachment 3.1A 4A SPA17-011-31A4A.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
    SERVICES PROVIDED, CATEGORICALLY NEEDY (page as it wil appear in new manual)
    (SPA011 – 4 of 15) Page 4a
    State Plan Amendment 2017-011 Attachment 3.1A 4A with tracked changes SPA17-011-31A4A-markup.doc SAME MANUAL PAGE: mark up that shows changes
    (SPA011 – 5 of 15) Page 4a
    State Plan Amendment 2017-011 Attachment 3-1B 2h SPA17-011-31B2h.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
    SERVICES PROVIDED, MEDICALLY NEEDY (page as it wil appear in new manual)
    (SPA011 – 6 of 15) Page 2h
    State Plan Amendment 2017-011 Attachment 3-1B 2h SPA17-011-31B2h-markup.doc SAME MANUAL PAGE: mark up that shows changes
    (SPA011 – 7 of 15) Page 2h
    State Plan Amendment 2017-011 SPA17-011-31B4b.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
    SERVICES PROVIDED, MEDICALLY NEEDY (page as it wil appear in new manual)
    (SPA011 – 8 of 15) Page 4b
    State Plan Amendment 2017-011 SPA17-011-31B4b-markup.doc SAME MANUAL PAGE: mark up that shows changes 1. IA Public Notice
    2. IA Manual Summary
    3. IA fiscal Impact
    (SPA011 – 9 of 15) Page 4b
    DDS Standards for Certification, Investigation and Monitoring – Redline DDS-Stnds-Redline.doc DDS STANDARDS for Certification, Investigation, an Monitoring for Center-Based Community Services  1. Summary DDTCS-CHMS 2. Info
    (SPA011 – 10 of 15) entire manual, mark up that shows changes
    DDS Standards for Certification, Investigation and Monitoring DDS-Stnds-Clean.doc DDS STANDARDS for Certification, Investigation, an Monitoring for Center-Based Community Services
    (SPA011 – 11 of 15) entire manual, as it will appear
    CHMS-2-17 Provider Manual Update Transmittal Letter CHMS-2-17.doc letter that explains which parts of the CHMS manual have been changed
    (SPA011 – 12 of 15)
    CHMS-2-17 Provider Manual Update CHMS-2-17up.doc CHMS Manual mark up with changes. 1. Summary DDTCS-CHMS 2. Info
    (SPA011 – 13 of 15)
    DDTCS-2-17 Provider Manual Update Transmittal Letter DDTCS-2-17.doc letter that explains which parts of the DDTCS manual have been changed
    (SPA011 – 14 of 15)
    DDTCS-2-17 Provider Manual Update DDTCS-2-17up.doc DDTCS Manual mark up with changes. 1. Summary DDTCS-CHMS 2. Info
    (SPA011 – 15 of 15)
    Interested Persons and Providers Letter for State Plan Amendment 2017-010, Outpatient Behavioral Health Services and Inpatient Psychiatric Provider Manual Updates and Residential Community Reintegration Program Certification IPLtrSPA17-010.doc memo
    (SPA010 – 1 of 8)
    State Plan Amendment 2017-010 Attachment 3.1 A SPA010-Attach3-1A.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
    SERVICES PROVIDED, CATEGORICALLY NEEDY (page as it will appear in new manual – NO MARK UP AVAILABLE)
    (SPA010 – 2 of 8) Page 6c17a
    State Plan Amendment 2017-010 Attachment 3.1 B SPA010-Attach3-1B.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
    SERVICES PROVIDED, MEDICALLY NEEDY (page as it will appear in new manual – NO MARK UP AVAILABLE)
    (SPA010 – 3 of 8) Page 5f17a
    Residential Community Integration Program Certification ResCommReintCert.doc Residential Community Integration Program Certification
    (SPA010 – 4 of 8) entire manual as it will appear NO MARK UP AVAILABLE
    Inpatient Psychiatric (INPPSYCH-1-17) Provider Manual Update Transmittal Letter INPPSYCH-1-17.doc Letter that shows the changes to Manual Update for Inpatient Psychiatric Services for Under Age 21
    (SPA010 – 5 of 8)
    INPPSYCH-1-17 Provider Manual Update INPPSYCH-1-17up.doc Manual Update for Inpatient Psychiatric Services for Under Age 21
    (SPA010 – 6 of 8) entire manual as it will appear NO MARK UP AVAILABLE
    Outpatient Behavioral Health Services (OBHS-1-17) Provider Manual Update Transmittal Letter OBHS-1-17.doc Letter that shows the changes to Manual Update for Outpatient Behavioral Health Services
    (SPA010 – 7 of 8)
    OBHS-1-17 Provider Manual Update OBHS-1-17up.doc Manual Update for Outpatient Behavioral Health Services
    (SPA010 – 8 of 8) entire manual, mark up that shows changes
    Interested Persons and Providers Letter for Independent Assessment Manual IPLtrAR_IA.doc memo
    (AR_IA – 1 of 2)
    AR Independent Assessment Manual AR_IA_July_17.doc New manual for Independent Assessment 1. IA Public Notice
    2. IA Manual Summary
    3. IA fiscal Impact
    (AR_IA – 2 of 2)
    Interested Persons and Providers Letter for DDS Policy 1076 -Appeals IPLtrDDS1076.doc memo
    (1076 – 1 of 3)
    DDS Policy 1076 with Tracked Changes DDS1076-Appeals-markup.doc DDS Policy APPEALS Manual
    (1076 – 2 of 3) entire manual, mark up that shows changes 1. Summary Appeals
    2. Info Policy 1076 Appeals
    DDS Policy 1076 -Clean DDS1076-Appeals-clean.doc DDS Policy APPEALS Manual
    (1076 – 3 of 3) entire manual, as it will appear
    Interested Persons and Providers Letter for DDS Policy 1086 IPLtrDDS1086.doc memo
    (DDS1086 – 1 of 3)
    DDS Policy 1086 with tracked changes DDS1086-HDC-markup.doc DDS Human Development Center Admission and Discharge Rules Policy Manual
    (DDS1086 – 2 of 3) entire manual, mark up that shows changes 1. 1086 HDC Rules Summary

    2. 1086 Info

    DDS Policy 1086 DDS1086-HDC.doc DDS Human Development Center Admission and Discharge Rules Policy Manual
    (DDS1086 – 3 of 3) entire manual, as it will appear
    Interested Persons and Providers Letter for Medical Services Policy Manual Sections E-600 through E-670 and Appendix R IPLtrABLE.doc memo
    (ABLE – 1 of 2)
    Medical Services Policy Manual Sections E-600 through E-670 and Appendix R ABLE.pdf Able Act Policy Manual: Eligibility Factors, Contributions, Withdrawals, Expenses, Exclusions,
    (ABLE – 2 of 2) entire manual, as it will appear – NO MARK UP AVAILABLE
    Interested Persons and Providers Letter for Community and Employment (CES) 1915 (c) Waiver, DDSCES-1-17 Provider Manual Update and Certification Standards for CES Providers IPLtrDDSCES.doc memo C Waiver
    (CES – 1 of 5)
    DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards DDSCESCertStand-markup.doc DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards
    (CES – 2 of 5) entire manual, mark up that shows changes 1. Summary of Changes

    2. Info – CES Waiver
    DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards DDSCESCertStand.doc DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards
    (CES – 3 of 5) entire manual, as it will appear
    Developmental Disabilities Services Community and Employment Supports (DDSCES1-17) Provider Manual Update Transmittal Letter DDSCES-1-17.doc Letter that shows the changes to Manual Update for Arkansas Medicaid Health Care Providers – DDS Community and Employment Supports (CES)
    (CES – 4 of 5)
    DDSCES-1-17 Provider Manual DDSCES-1-17up.doc Manual Update for Arkansas Medicaid Health Care Providers – DDS Community and Employment Supports (CES)
    (CES – 5 of 5) entire manual, mark up that shows changes 1. Summary of Changes
    2. Info – CES Waiver
    Interested Persons and Providers Letter for Provider-Led Arkansas Shared Savings Entity (PASSE) Waiver and New Provider Manual IPLtrPASSE.doc memo
    (PASSE 1 of 5)
    Provider-led Arkansas Shared Savings Entity Program – Phase I PASSEWvr.pdf PASSE Program Information B Waiver
    1. Summary of PASSE
    2. Info & Financial Impact
    (PASSE 2 of 5)
    Provider-led Arkansas Shared Savings Entity Spreadsheet SpreadsheetPASSEWvr.pdf PASSE Information – Enrollment Projections, Costs
    (PASSE 3 of 5)
    PASSE-New-17 Provider Manual Update Transmittal Letter PASSE-New-17.doc letter that explains Provider-Led Arkansas Shared Savings Entity (PASSE) Program manual
    (PASSE 4 of 5)
    PASSE-New-17 Provider Manual Update PASSE-New-17up.doc New PASSE Manual
    (PASSE 5 of 5) entire manual, mark up 1. Summary of PASSE
    2. Info & Financial Impact
    Interested Persons and Providers Letter for Independent Assessment for Personal Care and Criminal Background Check Requirements for Providers IPLtrIA.doc memo
    (IA – 1 of 22)
    State Plan Amendment 2017-009 with Tracked Changes SPA17-009-markup.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
    SERVICES PROVIDED, CATEGORICALLY NEEDY (mark up that shows changes
    (IA – 2 of 22) Page 10aa
    State Plan Amendment 2017-009 SPA17-009.doc SAME MANUAL PAGE: as it will appear
    (IA – 2 of 22) Page 10aa
    ARChoices in Home Care Home and Community-Based 2176 Waiver (ARCHOICES-1-17) Provider Manual Update Transmittal Letter ARCHOICES-1-17.doc letter that explains changes to ARChoices In Homecare Home and Community-Based 2176 Waiver Manual
    (IA – 3 of 22)
    ARCHOICES-1-17 Provider Manual Update ARCHOICES-1-17up.doc ARChoices In Homecare Home and Community-Based 2176 Waiver Manual
    (IA – 4 of 22) entire manual, mark up that shows changes
    Child Health Services/Early and Periodic Screening, Diagnosis, and Treatment (EPSDT-1-17) Provider Manual Update Transmittal Letter EPSDT-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – EPSDT Manual
    (IA – 5 of 22)
    EPSDT-1-17 Provider Manual Update EPSDT-1-17up.doc Arkansas Medicaid Health Care Providers – EPSDT Manual change
    (IA – 6 of 22) Section II, mark up that shows changes IA required for certain home health clients
    1. IA Public Notice
    2. IA Manual Summary
    3. IA fiscal Impact
    Home Health (HOMEHLTH-1-17) Provider Manual Update Transmittal Letter HOMEHLTH-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – Home Health Manual
    (IA – 7 of 22)
    HOMEHLTH-1-17 Provider Manual Update HOMEHLTH-1-17up.doc Arkansas Medicaid Health Care Providers – Home Health Manual change
    (IA – 8 of 22) Section II, mark up that shows changes background check changes
    Hospice (HOSPICE-1-17) Provider Manual Update Transmittal Letter HOSPICE-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – Hospice Service manual
    (IA – 9 of 22)
    HOSPICE-1-17 Provider Manual Update HOSPICE-1-17up.doc Arkansas Medicaid Health Care Providers – Hospice Service manual changes
    (IA – 10 of 22) Section II, mark up that shows changes background check, IAs for personal care
    1. IA Public Notice
    2. IA Manual Summary
    3. IA fiscal Impact
    IndependentChoices (INCHOICE-1-17) Provider Manual Update Transmittal Letter INCHOICE-1-17.doc letter that expains changes to Arkansas Medicaid Health Care Providers – IndependentChoices Manual
    (IA – 11 of 22)
    INCHOICE-1-17 Provider Manual Update INCHOICE-1-17up.doc Arkansas Medicaid Health Care Providers – IndependentChoices Manual changes
    (IA – 12 of 22) Section II, mark up that shows changes various changes included background checks
    Personal Care (PERSCARE-1-17) Provider Manual Update Transmittal Letter PERSCARE-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – Personal Care manual
    (IA – 13 of 22)
    PERSCARE-1-17 Provider Manual Update PERSCARE-1-17up.doc Arkansas Medicaid Health Care Providers – Personal Care Manual changes
    (IA – 14 of 22) Section II, mark up that shows changes
    Private Duty Nursing Services (PDN-1-17) Provider Manual Update Transmittal Letter PDN-1-17.doc letter that explains changes to the Arkansas Medicaid Health Care Providers – Private Duty Nursing Services manual
    (IA – 15 of 22)
    PDN-1-17 Provider Manual Update PDN-1-17up.doc Arkansas Medicaid Health Care Providers – Private Duty Nursing Services Manual changes
    (IA – 15 of 22) Section II, mark up that shows changes background checks
    Physician (PHYSICN-3-17) Provider Manual Update Transmittal Letter PHYSICN-3-17.doc letter that explains changes to the Physician/ Independent Lab/CRNA/Radiation Therapy Center manual
    (IA – 17 of 22)
    PHYSICN-3-17 Provider Manual Update PHYSICN-3-17up.doc Physician/ Independent Lab/CRNA/Radiation Therapy Center manual changes
    (IA – 18 of 22) Section II, mark up that shows changes IA requirement
    1. IA Public Notice
    2. IA Manual Summary
    3. IA fiscal Impact
    Rural Health Clinic (RURLHLTH-1-17) Provider Manual Update Transmittal Letter RURLHLTH-1-17.doc letter that explains changes to the Rural Health Clinic Services manual
    (IA – 19 of 22)
    RURLHLTH-1-17 Provider Manual Update RURLHLTH-1-17up.doc Rural Health Clinic Services manual changes
    (IA – 20 of 22) Section II, mark up that shows changes IA requirement
    1. IA Public Notice
    2. IA Manual Summary
    3. IA fiscal Impact
    Section I (SecI-3-17) All Provider Manuals Update Transmittal Letter SecI-3-17.doc letter that explains the changes to the Arkansas Medicaid Health Care Providers – All Providers manual
    (IA – 21 of 22)
    SecI-3-17 All Provider Manuals Update SecI-3-17up.doc Arkansas Medicaid Health Care Providers – All Providers manual
    (IA – 22 of 22) Section II, mark up that shows changes IA requirement
    1. IA Public Notice
    2. IA Manual Summary
    3. IA fiscal Impact

    Medicaid Saves Lila

    Published on by medicaidsaveslivesLeave a comment

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    This is my sweet girl, Lila. She’s active and intelligent. She loves to swing, eat blackberries, and paint. Don’t you dare turn your back on her because she’s mischievous too! She loves her friends, family, and kitty-cats. She is absolutely the most wonderful thing I’ve ever done with my life, and she just so happens to have Down Syndrome.

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    She might smile a lot, but her life hasn’t been easy. Born almost a month early due to multiple complications, Lila spent some time in the NICU. She’s overcome multiple illnesses and surgeries, including open heart surgery soon after her first birthday and many others since. In fact, we have received 2 new diagnoses this year alone, and she’ll have at least one surgery.

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    My husband and I are proud Arkansans. We’re educated, hard-working, tax-paying citizens. At the time of Lila’s birth, we lived in another state. Despite the fact that we both had good jobs and primary insurance coverage, we struggled to provide for her needs. When we moved back to Arkansas, Lila was significantly delayed in many areas.

    IMG_6519 Our friends told us about TEFRA, a type of Medicaid funding that provides for disabled children and that requires the family to pay a premium. Our primary insurance pays first for all that it will cover, and Medicaid makes sure that Lila doesn’t go without the rest. We gladly pay a monthly fee for this essential assistance!

    Lila now receives medical treatments that she needs from specialists and Occupational, Physical, and Speech therapy. She attends a school where she is loved and accepted, and they practice important skills in the classroom to prepare her for mainstream Kindergarten. Lila is constantly learning the necessary skills to be independent: speaking new words, learning to feed herself, to dress herself, and to climb stairs. One of my favorite moments was the first time I ever heard her say, “Ma Ma.” Can you imagine waiting 4 years to hear that?

    IMG_2776We never expected to need Medicaid. Even though we’d paid taxes for years for Medicaid, we didn’t know that a person’s life can change drastically in a moment – a car accident, a stroke, a job loss, a cancer diagnosis, a chromosomal difference – to cause them to need Medicaid. We thought that if we worked hard enough, we could take care of ourselves and Lila. But no matter how hard we work or what we give up, we just can’t afford to provide for all of Lila’s needs. Now, because of Medicaid, Lila is thriving, and we’re not being crushed under the weight of Lila’s ever-growing medical debt. We have hope that she will continue to develop and someday be a valued, contributing member of society. We are incredibly thankful for Medicaid.

    We tell everyone we can how essential Medicaid is! Lila has visited the Capitol and state lawmakers multiple times to represent herself and friends like her. Since she can’t speak much yet, my husband and I tell them how much Medicaid is literally saving lives. I can’t wait for the day that Lila will tell them herself. She brings a beauty and light to this dark world, and we will never stop fighting for her!

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