State Anticipates Medicaid Waiver Approval in January

By Christine Jordan Sexton

January is the new target date for final approval of the state’s Medicaid 1115 extension.

Agency for Health Care Administration Secretary Liz Dudek told members of the KidCare Coordinating Council on Friday that the December holidays will slow down talks between the states and the federal government, and that she now expects the Centers for Medicare and Medicaid Services to grant final approval to the sweeping waiver next month.

The waiver is vital for the state because it provides the regulatory framework the state needs to implement a mandatory Medicaid managed care program for all patients, from the cradle to the grave. The state must secure the existing Medicaid 1115 before implementing the new program, which will require amendments. Part of the Medicaid changes include a fundamental overhaul of the state’s Medically Needy program including premium requirements. Medically Needy serves people who have suffered catastrophic illness and become eligible for the safety net Medicaid program.

“I’m guessing that the  issue of the premium will be of interest to them (CMS),” Dudek said.

Dudek’s comments to the KidCare Coordinating Council follow remarks made by Gov. Rick Scott, who earlier in the day said he was disappointed that CMS had not acted on the Medicaid 1115 waiver or the proposed amendments to it that the state has filed with the federal government.

Dudek also told the KidCare Coordinating Council that since the Legislature passed the mandatory managed Medicaid program she has spent quite some time educating people about managed care.

“It’s not new; managed care has been around for a really long time,” said Dudek, who said she’s been enrolled in the Tallahassee HMO, Capital Health Plan, since 1984.

Long-term-care patients will be the first Medicaid patients required to be enrolled in managed care. That requirement kicks in fall 2013. Other Medicaid patients — women and children, among others — will be required to be enrolled in managed care the following year.

The group met to finalize its recommendations for the state’ children’s health insurance program. Deputy Secretary Kim Berfield, who ran the meeting, abstained from voting on any recommendations,as did representatives of the Agency for Health Care Administration and the Department of Children and Families. Policy generally  has been that state agencies that are responsible for the KidCare initiative don’t weigh in on legislative recommendations.

Rich Robletto, Florida Healthy Kids executive director, did vote on recommendations. Florida Healthy Kids technically is not a state agency although it is established in statute and its program is financed in part with state dollars.

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