Providers: PASSE Information

This information regards Act 775 (Provider Led Organized Care). If you haven’t read that, please do.

Deadlines are approaching with the formation of the PASSEs. The letter of intent deadline was extended to June 15, but many want your commitment by June 1. That being said, some of you still have questions.

First of all, will you be affected? You may or may not serve Tier 2 and/or Tier 3 patients of the BH and/or DDS populations. If you don’t, this may not affect you. However, if you want to keep your options open to serve them in the future, you probably need to at least participate in PASSEs. In the DD population, a Tier 1 patient can become a Tier 2 or 3 simply by being accepted into the Waiver program, but as you know, with the long waiting list, they could continue to receive services from their current providers. If you aren’t participating, that person will have to find another provider.

How many PASSEs are there? Why does this seem so secretive? Well, there are at least 4 forming. One PASSE has been pretty public, has released some plans, and were involved in passing the law.  They have held one public meeting. Others have formed and are trying to meet the regulations by June 15. These are common business practices, and some can’t release info until legalities are finalized. I hope to see public meetings from the others soon. It’s a pretty competitive situation right now, so a lot of information is not public. Each PASSE will try to convince you as to why you should invest with them. They are competing since there are only so many partners and investors available. There is a time limit for them, but you still have a little time to make a good investment decision. However, if you report to a board, you probably want to get them info as soon as possible.

Why should you invest? Part of the rules are that each PASSE must collect a savings/investment fund by December 2017 to be able to assume risk of managing funds for Tiers 2 and 3 of DDS and BHS. So that’s one reason each PASSE needs investors to give them money. Investors in a PASSE take on the risk together but also share in the rewards if money is saved. If each PASSE does not raise enough money and show a diverse group of partners to serve each need around the state, they will not pass certification. That’s why it’s pretty competitive to get you to invest with them and only them.

How are investment and participation different? As I understand it, participation requires nomoney from you. You can officially participate with any or all PASSEs once they’re certified to take on clients in order to be “in network” for the people they manage Medicaid funds for.

Any other important info? Each affected client will be attributed to one PASSE once he/she has received the Independent Assessment. The patient or caregiver will have 90 days to change to another PASSE. As said before, if you’re not a participant in that PASSE, you may lose the client. The Independent Assessment will determine what services are medically necessary for each patient, so you might expect some changes there. A lot of details have yet to be worked out.

Where can you get details about each PASSE? If you want to invest or hear more from each PASSE, just send me your email address, and I’ll send it to them. They will send the info they’re allowed to share.

AR Works Changes – How Legislators Voted

SB3 | Act 6 – TO AMEND ARKANSAS WORKS TO REDUCE INCOME ELIGIBILITY LIMITS AND IMPOSE WORK REQUIREMENTS; TO ALLOW THE FLEXIBILITY TO SELECT WHETHER TO BECOME AN “ASSESSMENT STATE” OR A “DETERMINATION STATE”; AND TO DECLARE AN EMERGENCY.

MSL Live on KABF 88.3

Lainey, our Founder, is going live tonight at 5pm on KABF 88.3 with 4 other panelists to talk about the state of Arkansas healthcare! We hope you’ll join her:

  • call in: 501-433-0088.
  • email questions/ comments: SpeakupAR@gmail.com
  • Listen http://www.kabf.org

Panelists are:

  • Marquita Little, Health Policy Director, AACF
  • John Sufna, Ph.D., Assistant Professor, Department of Psychiatry, UAMS
  • ShaRhonda Love, Executive director at Arkansas Minority Health Commission
  • Dianna Varady, Director, Arkansas Autism Resource and Outreach Center
  • Elaine Morrow, Founder of Medicaid Saves Lives

Speak Up Arkansas is a one-hour show which hopes to convey an “around the kitchen table” informal discussion that will give you needed information and perspective. The show and panelists hope you’ll call or email to ask about where or how to access services and learn more about navigating the systems.

The show usually starts with each panel member having 5 minutes to provide information about the particular focus area of their health practice, program, or policy work. This is a chance for all listeners to learn about the importance of health care and healthy practices, what services might be available, or what actions they can take to engage or learn more.

April 2017: Opportunities to Communicate!

A message from the Arkansas Provider Coalition:

Dear providers, beneficiaries, parents of beneficiaries, and other relevant stakeholders –

Beginning Monday, April 3, and continuing every Monday through April 24, DHS will resume large group meetings with stakeholders regarding the Behavioral Health and Developmental Disabilities client journey and transition of individuals into the Provider-Led Entity model. DHS will seek input from the key stakeholders regarding their roles and responsibilities to ensure the timely and effective launch of this initiative.

The meetings will be from 1:30 – 3:30 P.M., and will be held at St. Vincent Hospital’s Main Auditorium*.

The first meeting will focus on the population of beneficiaries with behavioral health needs and their client journey into the Provider Led Entity model. Our second meeting will focus on the developmentally disabled population and their client journey into the Provider-Led Entity model.

All are welcome to attend either in person, or via the web at: http://bit.ly/2mSKp9D You may register for all four meetings using the link above. If you are unable to attend the meetings in person or online, the sessions will be recorded and posted to the Arkansas Medicaid website (https://www.medicaid.state.ar.us/).

*The Main Auditorium is located in the Center for Education, which is directly across the street from the parking garage. There is a fountain in front of the entrance.

AHCA – Contact U.S. Senators & Representatives

Many of us feel overwhelmed by the information coming out about the American Health Care Act. Whether you support or oppose it, you need to let your federal representatives know how you feel.

If you’re not sure whether you support or oppose it, read the report from the House Budget Committee and the latest official information about the bill.

Some of you may fully support it, and it always helps to contact your legislators and tell them exactly what you like about it so those things won’t change.

We’ve seen many lawmakers oppose it, and they’re making amendments now to improve the bill. Our own Senator Cotton released a statement saying he can’t support it even with the recent amendments, while Westerman thinks it’s very patient-centered. Read about how our other Congressmen plan to vote. This bill has the capability to be devastating for Medicaid recipients. If this bill affects you, you need to contact all Arkansas US Senators and Representatives. Tell them what’s important for you.

Many National Advocacy groups and organizations are concerned about the AHCA, and they’ve asked Congress to protect Medicaid by changing what’s currently written.

The following is information provided by the Arkansas Advocates for Children and Families:

“This week the U.S. House of Representatives is scheduled to consider the American Health Care Act (AHCA), a bill that would repeal many provisions in the Affordable Care Act (ACA) and impose a per capita cap on the Medicaid program. In its current form, the bill would be a major step backward for health care coverage for our children, their parents, seniors, and the disabled.”

Read more about the AACF’s concerns.

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“In exchange for cutting and capping funds, states are allowed unprecedented flexibility to set eligibility standards, benefits, families’ out-of-pocket costs, and provider payments.”

“Under the proposed AHCA, the children in the state who rely on ARKids First are at risk of losing the coverage they need and deserve.”

“The Medicaid reductions would also translate into a loss of coverage, fewer benefits, and lower provider payments… including [for] those with special health care needs like autism, Down syndrome, and other conditions that require special care.”

Make sure you contact US Congressmen, list the bill (AHCA), and briefly explain how it will affect you.

More from the AACF: http://www.aradvocates.org/aacf-statement-on-the-american-health-care-act-ahca/

Regular Session Bills to Watch (AR 91st General Assembly)

The Regular Session of the 91st General Assembly began on Monday, January 9, 2017. Bill filing began on Tuesday, November 15, 2016, and the final deadline to file legislation was on Monday, March 6. The session ended on Monday, April 3, 2017. The amount of bills submitted that affect Medicaid may seem overwhelming, but this list will give you access to each bill’s history, actual language and details, as well as how your Legislators voted for these issues.


Passed

HB1706 | now Act 775 – TO CREATE THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; TO DESIGNATE THAT A RISK-BASED PROVIDER ORGANIZATION IS AN INSURANCE COMPANY FOR CERTAIN PURPOSES UNDER ARKANSAS LAW; AND TO DECLARE AN EMERGENCY.

HB1901 | now Act 958 – TO CREATE THE VOLUNTEER HEALTH CARE ACT.

HB1283 | now Act 902 – AN ACT FOR THE DEPARTMENT OF HUMAN SERVICES – DIVISION OF AGING AND ADULT SERVICES APPROPRIATION FOR THE 2017-2018 FISCAL YEAR.

SB195 | now Act 835 – AN ACT FOR THE DEPARTMENT OF HUMAN SERVICES – DIVISION OF DEVELOPMENTAL DISABILITIES SERVICES APPROPRIATION FOR THE 2017-2018 FISCAL YEAR.

HB1284 | now Act 852 – AN ACT FOR THE DEPARTMENT OF HUMAN SERVICES – MEDICAID EXPANSION PROGRAM APPROPRIATION FOR THE 2017-2018 FISCAL YEAR.

HB2177 | now Act 892 – TO CLARIFY THE PROPER ADMINISTRATION BY THE DEPARTMENT OF HUMAN SERVICES OF THE FEDERAL REGULATIONS PERTAINING TO POST-ELIGIBILITY TREATMENT OF INCOME OF INSTITUTIONALIZED INDIVIDUALS OF LONG- TERM CARE MEDICAID.

HB1954 | now Act 802 – TO REQUIRE A PROGRAM SAVINGS PLAN FOR THE MEDICAID PROVIDER-LED ORGANIZED CARE SYSTEM.

SB564 | now Act 978 – TO CLARIFY THE SCOPE OF HEALTHCARE FRAUD; AND TO UPDATE THE MEDICAID FRAUD ACT AND THE MEDICAID FRAUD FALSE CLAIMS ACT.

HB1162 | now Act 141 – TO AMEND ARKANSAS TAX LAW CONCERNING INCOME TAX, SALES AND USE TAXES, AND THE SOFT DRINK TAX; AND TO SUPPLEMENT THE ARKANSAS MEDICAID PROGRAM TRUST FUND TO OFFSET DECREASED DEPOSITS FROM TAX REVENUES.

HB1033 | now Act 50 – TO AMEND INITIATED ACT 1 OF 2000, ALSO KNOWN AS THE TOBACCO SETTLEMENT PROCEEDS ACT, TO REDUCE THE DEVELOPMENTAL DISABILITIES WAITING LIST; AND TO DECLARE AN EMERGENCY.

HB1025 | now Act 46 – TO AMEND THE PRESCRIPTION DRUG MONITORING PROGRAM ACT TO ALLOW ACCESS TO THE ARKANSAS MEDICAID PRESCRIPTION DRUG PROGRAM

SB81 | now Act 83 – AN ACT FOR THE OFFICE OF MEDICAID INSPECTOR GENERAL APPROPRIATION FOR THE 2017-2018 FISCAL YEAR.

HB1200 | now Act 120 – AN ACT FOR THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES – REYNOLDS CENTER ON AGING, BOOZMAN COLLEGE OF PUBLIC HEALTH, ARK. BIOSCIENCES INSTITUTE, & THE AREA HEALTH ED. CENTER IN HELENA APPROPRIATION FOR THE 2017-2018 FISCAL YEAR.

SB146 | now Act 203 – TO AMEND THE LAWS CONCERNING TELEMEDICINE; AND TO CREATE THE TELEMEDICINE ACT.

HB1491 | now Act 230 – AN ACT FOR THE DEPARTMENT OF HUMAN SERVICES – DIVISION OF MEDICAL SERVICES GENERAL IMPROVEMENT APPROPRIATION.

HB1016 | now Act 517 – TO CONVERT THE HOSPITAL REIMBURSEMENT SYSTEMS UNDER THE ARKANSAS MEDICAID PROGRAM TO DIAGNOSIS-RELATED GROUP METHODOLOGY.

HB1919 | now Act 605 – TO CODIFY THE PROCESS FOR THE REVIEW OF RULES IMPACTING STATE MEDICAID COSTS; AND TO EXEMPT MEDICAL CODES FROM THE RULE-MAKING PROCESS AND LEGISLATIVE REVIEW AND APPROVAL.

HB1501 | now Act 591 – TO MODIFY AND REPEAL LANGUAGE REFERENCING THE SUPERSEDED ELDERCHOICES PROGRAM.

HB1626 | now Act 568 – TO AMEND THE PROHIBITION OF PHOTOGRAPHY IN LONG-TERM CARE FACILITIES.

HB1264 | now Act 546 – TO PROVIDE FOR REIMBURSEMENT FOR HEALTHCARE SERVICES PERFORMED BY A WALK-IN CLINIC OR EMERGENT CARE CLINIC WHEN THE PATIENT DOES NOT HAVE A PRIMARY CARE PROVIDER ASSIGNED.

SB206 | now Act 699 – TO AVOID UNNECESSARY EXPANSION IN MEDICAID COSTS AND SERVICES RELATED TO REHABILITATIVE SERVICES FOR PERSONS WITH MENTAL ILLNESS; AND TO CODIFY THE REHABILITATIVE SERVICES FOR PERSONS WITH MENTAL ILLNESS MORATORIUM.

HCR1012 | approved by Gov – TO ENCOURAGE THE GOVERNOR TO SUBMIT A STATE PLAN AMENDMENT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO PROVIDE ACCESS TO COVERAGE FOR MIGRANT CHILDREN AND PREGNANT WOMEN FROM THE COMPACT OF FREE ASSOCIATION ISLANDS.

  • Check history
  • Senate votes – concurred
  • House votes – concurred
  • Read bill

HB1646 | now Act 745 – TO AMEND VARIOUS PROVISIONS OF THE ARKANSAS CODE CONCERNING PUBLIC EDUCATION.

SB196 | now Act 1045 – AN ACT FOR THE DEPARTMENT OF HUMAN SERVICES – DIVISION OF MEDICAL SERVICES APPROPRIATION FOR THE 2017-2018 FISCAL YEAR.

HB1183 | now Act 1092 – TO PROVIDE CONSISTENCY AND EFFICIENCY OF CHIROPRACTIC COVERAGE IN THE ARKANSAS MEDICAID PROGRAM; AND TO ALLOW MEDICAID RECIPIENTS DIRECT ACCESS TO A CHIROPRACTIC PHYSICIAN WITHOUT REFERRAL FROM A PRIMARY CARE PHYSICIAN.

 


Withdrawn

HB1803 | WITHDRAWN – TO CREATE THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; TO IMPOSE AN INSURANCE PREMIUM TAX ON RISK-BASED PROVIDER ORGANIZATIONS; AND TO DECLARE AN EMERGENCY.

SB765 | WITHDRAWN – TO HARMONIZE THE INTERPRETATION OF FEDERAL MEDICAID REGULATIONS BY THE DEPARTMENT OF HUMAN SERVICES AND THE OFFICE OF MEDICAID INSPECTOR GENERAL IN REGARDS TO PROVIDER AUDITS.

HB1916 | WITHDRAWN – TO REQUIRE ADVANCED PRACTICE REGISTERED NURSES TO USE THEIR OWN MEDICAID PROVIDER NUMBER OR A MODIFIER TO A MEDICAL CODE WHEN BILLING THE ARKANSAS MEDICAID PROGRAM FOR REIMBURSEMENT FOR HEALTHCARE SERVICES.


UNRESOLVED – When the session ended, these were still in committee:

HB1878 – TO CREATE THE MEDICAID PATIENT BILL OF RIGHTS.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB1809 – TO REFORM MEDICAID SERVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES; AND TO DECLARE AN EMERGENCY.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

SB593 – TO REFORM THE HEALTHCARE DELIVERY SYSTEM WITHIN THE ARKANSAS MEDICAID PROGRAM FOR SERVICES TO INDIVIDUALS WITH BEHAVIORAL HEALTH DIAGNOSES AND DEVELOPMENTAL DISABILITIES.

  • Check status & upcoming events
  • Senate votes – referred to committee
  • House votes
  • Read bill.

HB1903 – TO CREATE THE ENHANCED ELIGIBILITY AND AUTHENTICATION ACT.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB2124 – TO ELIMINATE THE ASSET OR RESOURCE TEST FOR LONG-TERM CARE MEDICAID WITHIN THE ARKANSAS MEDICAID PROGRAM FOR VETERANS.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB2145 – TO CREATE THE MEDICAID PROVIDER-LED ORGANIZED CARE ACT; TO IMPOSE AN INSURANCE PREMIUM TAX ON RISK-BASED PROVIDER ORGANIZATIONS; AND TO DECLARE AN EMERGENCY.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB1271 – TO CREATE THE ARKANSAS HEALTH INSURANCE INNOVATION ACT OF 2017; AND TO DECLARE AN EMERGENCY.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB1300 – TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES TO PRIORITIZE SPENDING WITH THE DEPARTMENT AND THE ARKANSAS MEDICAID PROGRAM TO FULLY FUND HOME- AND COMMUNITY-BASED SERVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB1810 – TO CLARIFY AND ESTABLISH AN APPROPRIATE MEDICAID REIMBURSEMENT METHODOLOGY FOR SMALL INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES; AND TO DECLARE AN EMERGENCY.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

SB603 – TO PROVIDE NECESSARY MEDICAID FUNDING TO COVER INCREASES IN COSTS INCURRED BY RESIDENTIAL CARE FACILITIES AND ASSISTED LIVING FACILITIES; AND TO DECLARE AN EMERGENCY.

  • Check status & upcoming events
  • Senate votes – referred to committee
  • House votes
  • Read bill

SB604 – TO ESTABLISH THE MEDICAID REIMBURSEMENT ADEQUACY COMMISSION; TO PROVIDE FOR REGULAR REVIEWS OF MEDICAID REIMBURSEMENT METHODOLOGIES; AND TO DECLARE AN EMERGENCY.

  • Check status & upcoming events
  • Senate votes – referred to committee
  • House votes
  • Read bill

SB756 – TO IMPLEMENT COST SAVINGS AND MANAGE GROWTH IN OUTPATIENT BEHAVIORAL HEALTH PROGRAMS DURING THE PERIOD OF TRANSITION TO PROVIDER-LED ORGANIZED CARE.

  • Check status & upcoming events
  • Senate votes – referred to committee
  • House votes
  • Read bill

SB175 – TO REQUIRE MEDICAID PROVIDERS AND GOVERNMENT OFFICIALS TO DISCLOSE OF CONFLICTS OF INTEREST.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB1981 – TO AUTHORIZE ADMINISTRATIVE SERVICES ORGANIZATIONS TO DELIVER HEALTHCARE SERVICES TO SPECIFIC MEDICAID POPULATIONS; AND TO REFORM THE ARKANSAS MEDICAID PROGRAM.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

SB503 – TO PROVIDE FOR CONSISTENT TREATMENT IN REIMBURSEMENT FOR THE EDUCATION OF ARKANSAS STUDENTS DURING PLACEMENT IN A FACILITY IN A BORDER STATE.

  • Check status & upcoming events
  • Senate votes – referred to committee
  • House votes
  • Read bill

SB434 – TO REMOVE THE ENROLLMENT CAPS IN THE LIVING CHOICES ASSISTED LIVING MEDICAID WAIVER PROGRAM.

  • Check status & upcoming events
  • Senate votes – referred to committee
  • House votes
  • Read bill

HB1502 – TO CREATE AN EXEMPTION TO THE DEFINITION OF RESIDENTIAL CARE FACILITY AND THE DEFINITION OF ASSISTED LIVING FACILITY.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

SB355 – TO TERMINATE THE MEDICAID EXPANSION PROGRAM, ALSO KNOWN AS THE HEALTH CARE INDEPENDENCE PROGRAM WHICH IS COMMONLY KNOWN AS THE “PRIVATE OPTION” AND THE ARKANSAS WORKS PROGRAM.

  • Check status & upcoming events
  • Senate votes – referred to committee
  • House votes
  • Read bill

HB1182 – TO AUTHORIZE THE ARKANSAS MEDICAID PROGRAM TO ALLOW AN ADVANCED PRACTICE REGISTERED NURSE TO BE A PRIMARY CARE PROVIDER.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

SB120 – TO AMEND ARKANSAS TAX LAW CONCERNING INCOME TAX, SALES AND USE TAXES, AND THE SOFT DRINK TAX; AND TO SUPPLEMENT THE ARKANSAS MEDICAID PROGRAM TRUST FUND TO OFFSET DECREASED DEPOSITS FROM TAX REVENUES.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill

HB1257 – TO CREATE THE COMMUNITY HEALTH WORKER ACT.

  • Check status & upcoming events
  • Senate votes
  • House votes – referred to committee
  • Read bill