Tag: medicaidmatters

Laura’s Story: Medicaid Saves Caregivers

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IMG_9901These two are my adult daughter and granddaughter. My daughter has developmental delays and multiple types of mental illness. My granddaughter has Down syndrome, Dyspraxia, and ADHD. Without Medicaid they will not have the therapies, medications, and medical care they need to live productive lives.

We are grandparents raising this little girl, and we are guardians to my daughter. We can’t make enough money to pay for private insurance for them or to pay out of pocket for these much needed services, therapies and medications. I fight Fibromyalgia, Lupus, and cancer. I don’t receive Medicaid. The stress of worrying if these 2 young ladies will still have medical care makes my health suffer greatly. I ask that Medicaid not be cut, that services are not capped so that all of those like my daughter and granddaughter can continue to get the treatments, therapies and medications they so desperately need.

Senate Healthcare Bill Released

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Updated: 7/9/17 4:08 pm

By now, you’ve probably seen more than 10 different news stories about the Senate healthcare bill. Maybe 10 per day! But what’s the truth? Will it really cut Medicaid? Will it really affect everyone? Well, the only way for you to know is for you to read it yourself. And we can help you.

You need to read, but also, don’t stop responding. The Senate wants to vote on this bill as soon as they can come to an agreement. They’re having many negotiations behind closed doors. Let your voice be heard through those doors! These are the Arkansas Senators to contact:
Sen. John Boozman (202) 224-4843
Sen. Tom Cotton (202) 224-2353

If you’re not from Arkansas, this info pertains to you as well. Every call matters. Here’s the number for Senators across the nation:  866-426-2631

Find your states US Representative & contact his/her office

Find your state’s US Senator & contact his/her office

Contact information for all of AR Congressmen.

What’s truly in the bill?

Make sure to read the bill to form your own educated opinions. Click on the image below to access the full text, and  use the resources above to help you.
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Legislators of the Week – District 35

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These are the legislators that we’re writing this week. Eventually we’ll get to all of them! Tell them what Medicaid is doing for you. Tell them why you’re thankful for the help. Tell them why you need it! If you’re in this district, please try to actually meet with them soon.

Name Phone Address Email
Senator Jason Rapert (R) 501-336-0918 P. O. Box 10388
Conway, 72034		 Jason.Rapert@senate.ar.gov
Representative Clarke Tucker (D) 501-379-1767 111 Center Street, Suite 1900,
Little Rock, 72201		 clarke.tucker@arkansashouse.org

Sample of Voting Record on Medicaid Bills from the 2017 Legislative Sessions:

  • SB3 to reduce the eligibility for Arkansas Works and to impose a work requirement:
    • Rapert – FOR
    • Tucker – AGAINST
  • HB1706, Provider Led Managed Care:
    • Rapert – FOR
    • Tucker – 1st vote: non-voting; 2nd vote: FOR.
  • HB1033, which redirected the Tobacco Settlement Fund to reduce the DDS Waiver Waiting List:
    • Rapert – FOR
    • Tucker – FOR
  • Check out how they voted on the other bills.

Catch up on the Provider Led Model (PASSE)

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PASSE stands for Provider-owned Arkansas Shared Savings Entities, and this new Provider-led model is required by a law passed by the Arkansas State Legislature last spring. DHS has been told to achieve a certain amount of Medicaid cost savings, and the theory is that this model should achieve them through better management of care. Over the next year and a half, we will see a shift in the management of Medicaid care for certain recipients under the Developmental Disabilities Services and Behavioral Health Services Divisions of DHS through the implementation of this model.

During the transition time, each recipient will undergo an Independent Assessment to determine services given, and then each recipient will be assigned to one of the PASSEs. Right now, we don’t know how many PASSEs there will be or which partners each will include. That should all become clear after June 15, 2007. Once the recipient receives information about which PASSE he or she has been assigned to, he or she will have 90 days to switch to a new PASSE if desired. Everyone will be on a different timeline, so recipients won’t really be able to compare situations early on.

This transition will take place throughout 2017 and 2018 as PASSEs slowly take on responsibility. In 2019, the PASSEs will take on all responsibility of managing the care and funds for each recipient they’ve been assigned. Providers will then bill the PASSE for each client, which means that the providers have to participate in probably all PASSEs to be “in network” for their current clients and future clients.

As said before, this will only affect certain clients – classified as Tier 2 and Tier 3 – for both DD and BH. Tier 2 and 3 people are defined differently by DD and BH, but basically it’s determined by level of care needed.

As we’ve all seen, this is very complicated, and a lot of information has already been shared. Here’s your chance to catch up!

Basic questions answered

See DHS Presentations from public meetings that occurred in April 2017.

Read the law that was passed during this past spring session.

See DHS’s answers to your questions.

See in depth information from DHS about the PLM.

Legislators of the Week – District 2

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https://medicaidsaveslives.com/voice/

These are the legislators that we’re writing this week. Eventually we’ll get to all of them! Tell them what Medicaid is doing for you. Tell them why you’re thankful for the help. Tell them why you need it! If you’re in this district, please try to actually meet with them soon.

Name Phone Address Email
Senator

Jim Hendren

 479-787-6222 1607 Highway 72, S.E.
Gravette, 72736		 jim.hendren@senate.ar.gov
Representative Lane Jean 870-904-1856 1105 Lawton Circle
Magnolia, 71753		 l_jean@sbcglobal.net

Sample of Voting Record on Medicaid Bills from the 2017 Legislative Sessions:

  • SB3 from the Extraordinary Session of 2017 to reduce the eligibility for Arkansas Works and to impose a work requirement:
    • Hendren – FOR
    • Jean – FOR
  • HB1706, Provider Led Managed Care:
    • Hendren – FOR
    • Jean – FOR
  • HB1033, which redirected the Tobacco Settlement Fund to reduce the DDS Waiver Waiting List:
    • Hendren – FOR
    • Jean – FOR
  • Check out how they voted on the other bills.

Providers: PASSE Information

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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.

MSL Live on KABF 88.3

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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.