CMS-NYS Making Medicaid More Coordinated, Person-Centered

The Centers for Medicare & Medicaid Services (CMS) announced that CMS is partnering with the New York State Department of Health (NYSDOH) and the Office for People with Developmental Disabilities (OPWDD) to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.

"We are pleased to partner again with the State of New York to bring more person-centered care to Medicare-Medicaid enrollees," said CMS Tim Engelhardt, Director, CMS Medicare-Medicaid Coordination Office.  "We look forward to working together to provide Medicare-Medicaid enrollees with intellectual and developmental disabilities an opportunity to experience more integrated benefits and coordinated care."

Half of Medicaid Providers Not Available to Treat Patients, Report Finds

WASHINGTON — Large numbers of doctors who are listed as serving Medicaid patients are not available to treat them, federal investigators said in a new report.

“Half of providers could not offer appointments to enrollees,” the investigators said in the report, which will be issued on Tuesday.

Many of the doctors were not accepting new Medicaid patients or could not be found at their last known addresses, according to the report from the inspector general of the Department of Health and Human Services. The study raises questions about access to care for people gaining Medicaid coverage under the Affordable Care Act.

Oregon Families Fight New Provision of Affordable Care Act

SALEM, Ore. — Deana Copeland has cared for her 22-year-old, medically fragile daughter since she was born, but she's afraid that a new provision of the Affordable Care Act could force her to place her daughter in foster care.

Deana Copeland, right, has cared for
her daughter, Andrea Hood, since
she was born.

Her daughter, Andrea Hood, suffers from cerebral palsy, spina bifida and autonomic dysreflexia, a potentially life-threatening condition, and requires around-the-clock care. Copeland is both Hood's legal guardian and paid service provider, for which she receives $1,400 a month.

"I could never expect somebody else to address her needs the way I do," said Copeland, a Cornelius resident. "In our specific situation, it is going to cost the state exponentially more to do less care for Andrea if Andrea has to be cared for in a center."

That's because a new provision of the Affordable Care Act set to go into effect Jan. 1, 2014, would largely prohibit guardians from serving as the paid caregiver of an adult child with developmental disabilities. Disability rights advocates and state officials are fighting the provision and say it could restrict family flexibility and choice, especially for single parents who serve as guardians and use the caregiving allowance to stay at home.

Critics Turn to Academics To Do Cost-Benefit Analysis of OPWDD Services

STATEN ISLAND, N.Y.  -- Faced with a $90 million cut to the state Office of People With Developmental Disabilities, Staten Island advocates for the disabled have been highly critical of the borough's Albany lawmakers for not doing enough to prevent what amounts to a 4.5 percent reduction in aid. 

Donna Long and Laura Kennedy
are among those critical to the cuts.

But now Assemblyman Michael Cusick and one of the sharpest critics of the cuts to OPWDD, parent and activist Laura Kennedy -- who branded the reductions "cruel and shameful" -- told the Advance Thursday they've come up with a "plan of action" going forward.

5 Pending Medicaid Waivers to Watch in 2013

In the midst of the national push for Medicaid reform, one albatross is often cited by state policymakers for impeding their progress: the federal waiver process. The long and short of it is that it takes too long to get a waiver approved by the Centers for Medicare and Medicaid Services (CMS) if a state has an innovative idea to test. There are horror stories about waivers taking more than a year to be approved, even if they’ve been approved in the past and states are just looking to continue their programs. Six former governors (three Democrats and three Republicans) issued a report last year, bemoaning the problems with the waiver process and offering their recommendations for fixing it. CMS officials have acknowledged that it could be streamlined, though no specific improvements have been named or acted upon.