Session in South Carolina: 3 Weeks In and Already Busy

south carolina state house hearts for home care advocacy

Just three weeks into South Carolina’s session and we are already seeing a flurry of activity. This week was filled with numerous meetings and Governor McMaster’s first State of the State address.

Several House Ways and Means budget subcommittees and Senate Finance subcommittees met this past week to hear state agency budget requests for the next fiscal year. Chairman of the Healthcare Committee Murrell Smith has requested that the South Carolina Department of Health and Human Services (DHHS) work with a consulting group to gather data and calculate the amount of funding the Department will need, which may impact BAYADA’s Medicaid clients.

Additionally, this past Wednesday, Governor Henry McMaster delivered his first State of the State address to a joint session of the General Assembly. He highlighted recommendations from his Executive Budget proposals and noted his priorities, including tax relieve, job creation, education, and health care.

In the Governor’s budget, he is proposing an increase of funds to support South Carolinians with traumatic brain injuries to be able to get the rehabilitative care they need. It’s exciting to see the Governor support a cause that is important to so many families in South Carolina.

PS- March is Brain Injury Awareness Month! If you’d like to contact the Governor about his support of traumatic brain injury patients, please email me.

Work Continues on Transforming Medicaid

 Last month the North Carolina Department of Health and Human Services (DHHS) submitted an amendment to the 1115 demonstration waiver application, originally submitted in June 2016. This amendment is the next step in the transformation of NC Medicaid and NC Health Choice programs to managed care, driving the state’s goal to implement reform.  This system will address both the physical and behavioral health of North Carolinians. The proposed program design seeks to implement changes that advances high-value care, improves population health, engages and supports providers, and establishes a sustainable program with predictable costs.  Our BAYADA workgroup, made up of technical experts and leadership from across the organization, has reviewed and provided formal comments to both the program design and waiver application. Our comments focus on: ensuring beneficiary access to care; the viability of the provider network; minimizing administrative burden, and establishing meaningful metrics that support and reward quality.

Special thanks to our review BAYADA teams for sharing their insight and operational experience.

NC DHHS Takes Another Step Towards Managed Medicaid

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

Last week, North Carolina’s Department of Health and Human Services (DHHS) released two requests for information (RFI) as their next step towards Medicaid Managed Care.  Both requests, statement of interest and financial operations, focus on the organizations that intend to bid to be a pre-paid health plan (PHP) for Medicaid.  “This RFI is an important step toward implementing the proposed program design that DHHS released in August,” said DHHS Assistant Secretary for Medicaid Transformation Jay Ludlam.  “We look forward to continued input and collaboration from health care providers, health plans, and other stakeholders as we build the strongest possible Medicaid program for North Carolina.”  Comments are due to DHHS on November 22.  Our BAYADA workgroup’s next opportunity to provide input is on the proposed 1115 Waiver application, which is slated to be released at the end of this year or early 2018.

 

“649 Days Until Medicaid Managed Care Go-live” – Will Medicaid Meet Its Goal in NC?

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

 Last week, I attended the Medical Care Advisory Council (MCAC) meeting where Jay Ludlam the new NC Department of Health and Human Services (DHHS) Assistant Secretary for Medicaid Transformation presented the department’s program design for taking Medicaid into a managed care environment.  Having been on the job for less than three weeks, Ludlam said, “649 days until the Medicaid Managed Care go live date!”  While many steps need to occur before “go live”, including formal approval by Centers for Medicare and Medicaid Services (CMS), the department is aggressively working towards that goal.  I spoke with Mr. Ludlam after the meeting, not only to introduce BAYADA but also to express our concerns with the fast pace, and lack of details for how long-term services and supports will be incorporated into reform.  As you may recall, BAYADA formed a review team and has already submitted comments to the program design. The Government Affairs Office (GAO) will continue to participate in the discussion as the state formulates its plan.  Click to read Jay Ludlam’s complete bio.

Photo of Jay Ludlam link to his bio
Photo of Jay Ludlam link to his bio