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

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.

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/

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

2012 legislative session comes to a close

Over the weekend, legislators finally approved a budget and completed the longest ever omnibus session.  Below is a very thorough article provided by Kansas Health Institute's News Service on the results of the session.

Some highlights of the article:

• Waiting lists: $3.6 million in State General Funds (SGF) allotted to help reduce waiting lists.  This will be matched by federal funds, creating a total of $8.2 million for waiting lists.  Only a portion of this money will be directed to persons with developmental disabilities.  Projections estimate approximately 97 persons with DD will be served from the waiting lists.

• KanCare
• Included in the budget bill is a proviso to delay the inclusion of long-term DD services for one year.  The proviso includes language allowing programs to voluntarily participate in pilot programs.
• Legislators did not approve a special oversight committee for KanCare
• Lawmakers did approve funding ($1 million) requested by the Governor to update the Medicaid Management Information System for KanCare.  However they did not approve funding that the Governor sought for a statewide program to inform Medicaid beneficiaries about KanCare.  Nor did they approve funding sought by the Administration to create a new Medicaid Reform health Savings Account for KanCare.

Read More: KHI News Service

May 20, 2012

Gavels drop on 2012 Legislature: 

Longest ever wrap-up session ends after a budget plan is finally approved

In Memoriam: Representative Bob Bethell

Sad news came to us as we heard of the car accident that claimed the life of Representative Bob Bethell.

We all got to know Bob who came to Topeka as a reformer with a fixed perspective on DD issues. His perspective was that the system was in desperate need of reformation, and many things he suggested were strongly opposed and defeated by your advocacy.  It was a several years long struggle to work through those issues. Then over time he, and we,  came to know one another better, and his regard for your work grew each year. He became a strong supporter of your work, and a strong believer in the essential strength and integrity of the DD system. Wounds do heal in the political arena, and Bob became one of our strongest supporters.

He stood up for our work on many occasions, and that was true regardless of the prevailing politics of the day.

In his last few years in office, Bob became known as a RINO (Republican in Name Only), and wore the target without embarrassment or fear. He knew two things, first that he was a Republican in the strongest and most principled ways that he embraced his party’s traditions. And, second, he knew that being a Republican didn’t mean he had to put his principles and his independent thoughts on the shelf, and he wasn’t quiet about it, he spoke out on many issues which put him at odds with some within his own party.

We will always appreciate his work in the last few sessions, to bring light to our issues, to work with legislators on both sides of the aisle, to collaborate with us and seek our  input, and generally, we will appreciate the ways in which he and you and we grew to work in common cause on behalf of disability supports and services in Kansas.

Keep Bob’s family in your prayers.

Tom Laing,

Executive Director, InterHab

LEFT TO RIGHT: Representatives Jerry Henry, Barbara Ballard and Bob Bethell gather outside the Governor's office for the signing of
SB 210; the provider assessment bill passed in 2011.