On May 16 the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register Volume 76, Number 94, pages 28196-28207 its request for comment on opportunities for alignment under Medicaid and Medicare. CMS is seeking comments on opportunities to more effectively align benefits and incentives to prevent cost-shifting and improve access to care under the Medicare and Medicaid programs for individuals with both Medicare and Medicaid (“dual eligibles”). CMS says that the document also reflects CMS’ commitment to the general principles of the President’s Executive Order released January 18, 2011, entitled “Improving Regulation and Regulatory Review.” To be assured consideration, comments must be received no later than 5 p.m. See http://www.gpo.gov/fdsys/pkg/FR-2011-05-16/html/2011-11848.htm
On May 20 PA Representative Dan Frankel (D-Allegheny) is launching efforts to gain passage of legislation to restore Pennsylvania’s motorcycle helmet law. At a news conference in the Capitol he will announce the introduction of legislation to require additional insurance for motorcycle riders who choose not to wear a helmet. He also will introduce a bill to provide for special motorcycle license plates for riders under the age of 21. Representative Frankel will be joined by Christopher Hart, vice chairman of the National Transportation Safety Board, and other advocates. Dr. Kristen Mertz of the University of Pittsburgh, who co-authored a study on the impact of Pennsylvania’s 2003 repeal of the helmet requirement for motorcycle riders 21 and older, will also be at the news conference. The news conference will be held at 11 a.m. Monday, May 23 in the Capitol Media Center. See www.pahouse.com
Members of the Pennsylvania Behavioral Health Coalition, including PARF, are calling for the rejection of a House budget proposal that would reduce funding for cut behavioral health services. The House Republican budget proposal (HB 1485) proposal to cut $470 million from the Department of Public Welfare (DPW) budget would significant cuts to the Behavioral Health Services Initiative (BHSI), the Medical Assistance Transportation Program (MATP), and some aging services. In a letter to legislators, the coalition indicates that BHSI was cut by $4.3 million (8.26%) in the House budget proposal. If the House proposal is implemented, the BHSI budget will have been cut by $9.5 million since fiscal year 2007-2008, a 16.6 % cut over four years. In addition, the House proposal cuts $4.322 million from state mental health base dollars. The coalition says that while this cut is less than 1 %, when combined with the BHSI decrease, the overall impact on community based services results in a loss of over $8.5 million. In addition, the House budget proposal cuts $9.6 million (12.9 %) from the Governor’s proposed budget for MATP. The coalition points out that federal regulations require that the Medical Assistance Program assure that transportation is available for individuals to access needed services. FMI: See www.pahouse.com and www.pahousegop.com. For a copy of the budget bill see www.legis.state.pa.us. Contact parfmail@parf.org.
PARF and other members of Pennsylvania disability budget coalitions are calling on state legislators to restore the funding for home and community based services under Medicaid waivers to the 2010-11 current year levels. The funding for home and community based services would be cut in state budgets proposed by Governor Corbett and House Republicans. The House budget bill (HB 1485) retains the Governor’s proposal to eliminate $27 million in state funding for housing and food for people with intellectual disabilities. That move is seen by PARF and other members of the Pennsylvania Intellectual Disabilities and Autism Coalition as a terrible mistake that threatens to force thousands of people from their homes. PARF along with members of the Pennsylvania Disability Budget Coalition is also seeking to reverse proposed cuts in the state budget for services to people with cognitive and physical disabilities. Under the Governor’s budget, state funds for Services to Persons with Disabilities (CSPPPD), which includes the Independence, OBRA and CommCare waivers, would have increased by $20 million. However, the proposed decrease in federal funds would have resulted in a net decrease of 8%. DPW officials had indicated that funding at the Governor’s proposed level would be sufficient to continue the program, including annualizing previous expansions and providing for new people. The House Republican budget reduces funding for this program and combines it with reduced funding for Attendant Care and for the Aging Waiver, in a new line item called “Home and Community Based Services.” For Attendant Care (which includes both the waiver and state-only Act 150), both state and federal funds would have been decreased in the Governor’s budget, amounting to a 16% reduction. The House Republican budget cuts the Attendant Care line item further, combing it with reduced funding for CSPPPD and for the Aging Waiver in the new budget line item “Home and Community Based Services. FMI: For a copy of the budget bill see www.legis.state.pa.us and enter HB 1485. Contact parfmail@parf.org.
On May 23 Pennsylvania legislators are to take up a state budget bill (HB 1485) that calls for cuts to higher-education cuts which are less than Governor Tom Corbett has proposed and for savings from reducing Medicaid waste and fraud – which are $470 million more than considered by the Governor. The PA Senate will take up the budget bill after House passage. The PA legislature must pass the spending plan before the fiscal year begins on July 1. The $27.3 billion House spending plan (HB 1485) calls for a 15 percent cut for the 14 state-owned universities and a 25 percent cut to four universities outside the state system. The House bill calls for deeper cuts in Medicaid funding. Hospitals would receive $70 million less in state and federal payments for Medical Assistance. Up to 164,300 residents could lose access to health care through Medicaid. During his Senate confirmation hearing Acting Secretary of Public Welfare Gary Snyder said that there would be savings by finding fraud but that he could not offer a specific estimate until more study was done. FMI: See www.pahouse.com and www.pahousegop.com. For a copy of the budget bill see www.legis.state.pa.us. Contact parfmail@parf.org.
On May 8 the PA DPW Office of Developmental Programs issued its Developmental Programs Bulletin 00-11-05 entitled, Person/Family Directed Support (P/FDS) Waiver Amendment Effective July 1, 2009, and the corresponding attachments and its Developmental Programs Bulletin 00-11-04 entitled, Consolidated Waiver Amendment Effective July 1, 2009, and the corresponding attachments. ODP said that the purpose of the final bulletins is to transmit the Office of Developmental Programs Consolidated Waiver Amendment and Person/Family Directed Support (P/FDS) Waiver Amendment, as approved by the Centers for Medicare and Medicaid Services (CMS), effective July 1, 2009. The approved amendments to the waivers include the information on the rate setting methodologies, clarification and updates to participant direction opportunities, revisions to the ODP Quality Management Strategy and performance measures for each assurance area, and updates to service definitions and provider qualification criteria. The statements in the waiver amendments related to revenue reconciliation (Page 241 of the approved Consolidated ID Waiver recently approved by CMS ) are general and do not contain any language that would suggest the need for any changes from existing ODP policies relating to revenue reconciliation. ODP has not yet announced final starting revenue targets plus Period 1 Adjustments to revenue targets nor issued a notice to providers of the amount of supplemental payments and recoupments relating to the first four months of the current fiscal year. See www.odpconsulting.net
