Thursday, June 28, 2012

Supreme Court Rules to Uphold Affordable Health Care Act

This morning the Supreme Court of the United States (SCOTUS) issued its opinion on the Affordable Care Act (ACA).  Of most concern was the constitutionality of the law requiring individuals to purchase health insurance (or pay a fine).  In addition, the Court was determining whether the federal government could force states to share in the costs/administration of Medicaid to implement new reforms of the ACA.

Below is a "plain english" summary of the Supreme Court opinion as reported from the SCOTUS Blog:
http://scotusblog.wpengine.com/

In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.



Official opinion released by SCOTUS:
http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

From KHI:
http://www.khi.org/news/2012/jun/28/high-court-upholds-affordable-care-act/
A summary report on the Supreme Court ruling with detail on Kansas' response to ACA thus far and announcements of upcoming responses from Kansas officials

Wednesday, June 27, 2012

KanCare MCO's Announced

Amerigroup, United Healthcare and Sunflower State Health Plan, a subsidiary of Centene have been awarded contracts to manage services delivered to Medicaid recipients.

From KHI:
KanCare contracts signed
By Mike Shields
June 27, 2012


TOPEKA — Kansas officials today announced contract awards to three Medicaid managed care companies.

They also said the new KanCare program's projected savings over five years would be $1 billion instead of the $850 million previously forecast.

The three winning companies are Amerigroup, UnitedHealthcare and Sunflower State Health Plan, a subsidiary of Centene. The unsuccessful bidders were WellCare and Coventry.

The contract awards have been anxiously anticipated by many of the state's Medicaid service providers. The providers have been heavily courted by the competing managed care companies as they have vied to develop the provider networks they will need to serve the state's 380,000 Medicaid clients.

Federal officials must approve the contracts, rates and a Medicaid waiver before the administration of Gov. Sam Brownback can implement the Medicaid makeover plan first announced last November.
Brownback officials have said they aim to launch the KanCare program on Jan. 1, pending the needed approvals and reviews certifying that the contractors are ready.

KanCare would shift virtually all of the state's Medicaid enrollees into fixed-rate managed care plans. Currently, about 70 percent of the state's Medicaid population is served by managed care organizations.
Watch this space for additional information as this story develops.

Monday, June 11, 2012

Schedule for Public Forums on 1115 Waiver

The Kansas Department of Health and Environment (KDHE) has scheduled two public meetings on the topic of Kansas' Section 115 KanCare demonstration application:

June 18, 2012 at 2:00pm
Hughes Metropolitan Complex
Wichita State University
5015 E. 29th St. N
Wichita, Kansas

June 20, 2012 at 3:00pm
Memorial Hall Auditorium
120 SW 10th Ave.
Topeka, Kansas

Please plan on attending and recruit your fellow DD advocates to attend as well!

Please also note that the State is accepting public comment through the internet at:  http://www.kdheks.gov/hcf/kancare/

Wednesday, June 6, 2012

News Flash! Kansas Medicaid 1115 Waiver Submission Delayed

The Kansas Department of Health and Environment distributed a news release yesterday indicating they will re-submit a formal Section 1115 Waiver application to the Centers for Medicaid Services in July.  The 1115 waiver request must be approved by CMS in order for Governor Brownback's administration to implement KanCare.

Kansas originally submitted its request to CMS in late April.  Shortly after their submission, CMS passed new  requirements to the waiver approval process, requiring states to host public hearings on new waiver requests.

The Brownback administration has now requested that CMS not regard the April submission as their formal application, but instead await a new application to be submitted in July.  As per CMS's recently passed requirements, the state must host two public meetings to discuss the application.

The delay was caused by an oversight of consulting all tribal health organizations as is required by the State of Kansas' tribal consultation policy.  The delay and pending submission will allow the State to consult the tribal health organizations.  The State indicates they do not forsee this delaying implementation of KanCare in January 2013.

Learn more: KHI News Service

"Kansas asks to withdraw Medicaid 115 waiver request: State officials say they intend to resubmit in July"
June 5, 2012
by Mike Shields


Learn more: KDHE News Release

"Kansas to Submit Formal Section 115 Waiver Application in July, Extend KanCare Public Comment Period:
Additional comment period not expected to delay January 2013 Implementation of KanCare"
June 5, 2012

Lobbying prohibition contract language

Last week the Kansas Department of Social and Rehabilitation Services announced it would be adding new language to its contracts with service providers to add further restriction against service providers using state or federal funding to influence legislation.

While providers of service to persons with developmental disabilities are no longer under SRS's purview, SRS spokesperson explained that the Brownback administration is planning to add the new language to all state-administered contracts.  If implemented, this could indeed affect service-providers in the DD community.

Currently, there are already some restrictions from spending government money on lobbying, however this new language will take those restrictions further.  Below is an article from Kansas Health Institute explaining the state's lobbying prohibition language...

Lobbying prohibition added to SRS contracts
May 29, 2012
by Dave Ranney

http://www.khi.org/news/2012/may/29/lobbying-prohibition-added-srs-contracts/\




This proposed language by the State to add to all contracts with service providers also made a splash with national nonprofit organizations.  Below is a commentary written by Rick Cohen of  Nonprofit Quarterly:

Kansas Nonprofits Told to Sit Down and Shut Up
May 30, 2012
by Rick Cohen

http://www.nonprofitquarterly.org/policysocial-context/20420-kansas-nonprofits-told-to-sit-down-and-shut-up.html