Understanding the House Tax Bill

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!

    Senate pulls All-night Session to Vote on Skinny Repeal

    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.

    Making Sense of the Manuals for Public Comment

    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