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Tags Posts tagged with "HealthChoices"

HealthChoices

On July 14, the National MLTSS Health Plan Association submitted comments on the “Preserving Medicaid Funding for Vulnerable Population – Closing a Health Care-Related Tax Loophole” proposed rule. Per the Association:

This rule proposes to refine how CMS evaluates whether a health care-related tax is considered “generally redistributive.”

In our comments, we noted that we appreciate CMS’ efforts to strengthen the oversight and quality of Medicaid programs but raised concerns about the timelines and administrative burden on states, as well as the potential impact on individuals receiving long term-services and supports (LTSS).

The recommendations included:

  • Extending the transition period to three years for all states.
  • Providing clear implementation guidance and technical assistance to states.
  • Postponing finalization of the rule until further research and data analysis on provider-related taxes and impacts are conducted.

Read the full letter here.

In Pennsylvania, this rule would impact participants’ funding of approximately $1B in federal matching funds for HealthChoices, Community HealthChoices, and Behavioral HealthChoices. No immediate action is required. If you have any questions, contact Fady Sahhar.

As the state’s primary contractor for Medicaid-funded behavioral health (BH) care services (HealthChoices), Allegheny County DHS is responsible for $420M in state-managed care funding to deliver behavioral health services to approximately 260,000 county residents through its contracted partnership with Community Care Behavioral Health.

Historically, as the primary contractor to the state for the HealthChoices program, DHS has delegated its oversight and monitoring functions for this program to Allegheny Health Choices, Inc. (AHCI), and AHCI has done tremendous work helping the county to meet state obligations over the years. Increasingly however, the county has determined that making a structural change to bring monitoring and oversight in-house can streamline those functions and further strengthen the HC program for Allegheny County.

For this reason, the county, together with DHS, has made the decision to transition HealthChoices oversight and monitoring functions from AHCI to DHS, with expected changes to occur in the first quarter of 2023.

See below for further information: