ACAP and Commissioner Maggie Brooks Submit Final Recommendations to Medicaid Commission

As September ended, ACAP worked with Medicaid Commissioner Maggie Brooks, County Executive from Monroe County, New York, to present the Medicaid Commission with three Medicaid reform proposals.  ACAP’s proposals are:

1)   To renew a CMS initiative to analyze and publish Health Employer Data and Information Set (HEDIS^®) quality data for Medicaid managed care plans.

2)   To allow Medicaid managed care plans to participate in the Medicaid Drug Rebate Program currently restricted to fee-for-service Medicaid programs.

3)   Expand managed care coverage in Medicaid.

At a November 16 meeting (location to be announced later), Commissioners will vote on a short list – a “Chairman’s Mark” – of proposals selected from a catalog of reform concepts submitted by Commissioners and the public, including ACAP.

The short list of proposals approved by the Commission will be presented to Secretary Michael O. Leavitt in a final report on December 31, 2006, which is intended to provide recommendations to ensure the long-term sustainability of the Medicaid program.  The Department of Health and Human Services is expected to present the recommendations to Congress as well.

ACAP, NACHC Comment on HRSA Proposal to Modify Health Center Controlled Networks for HIT

On October 10, ACAP issued comments to the Health Resources and Services Administration (HRSA) on a proposed modification to a grant program called the Health Center Controlled Network (HCCN). Since 1994, HCCN grants have provided operational support to health networks that are controlled by health centers but comprised also of other community-based health entities. These networks strive to ensure access to health services for medically underserved populations. HRSA has proposed to use the HCCN grants solely to support the adoption of health information technology among HRSA's safety net providers.

ACAP requested that HRSA explicitly include safety net health plans in the list of health entities eligible to participate in HCCNs. In addition, ACAP suggested that the Department of Health and Human Services more broadly support adoption and utilization of health information technology among safety net plans and providers through Medicaid and SCHIP reimbursement.

NACHC also submitted extensive comments on the proposed change. Seeking to preserve HCCN's traditional role in enabling health centers to perform business and clinical operations more effectively, NACHC stated that HRSA should adopt a multi-faceted strategy for HIT investments that includes but is not limited to HCCNs. NACHC does not support restructuring the HCCN program to focus solely on HIT-related projects and feels as though HCCNs have effectively enabled health centers to perform critical business and clinical operations, and have promoted the expansion of the community health center program.

New York's F-SHRP Waiver Approved by CMS: Mandates More Managed Care

The Centers for Medicare and Medicaid Services (CMS) is requiring the State of New York to mandate managed care for new Medicaid populations.  New York’s five-year Federal-State Health Reform Partnership (F-SHRP) waiver was approved September 29, 2006.  With it, the State will mandate Medicaid managed care to the SSI population and to new geographic regions to realize savings that can be used to reform New York’s health system.  Reforms will include reducing excess capacity in the acute care system, shifting emphasis in long-term care from institutional-based to community-based settings, and expanding the use of health information technology.  For these and other goals, the Federal government will invest a five-year total of $1.5 billion in New York’s health system.  In return, the State will be required to generate waiver savings to offset the investment and meet a set of performance milestones included in the terms and conditions of the demonstration.