Medicaid pay to manage care of disabled gets OK

Rules governing payments to companies that will coordinate care for about 30,000 mentally ill or developmentally disabled Medicaid recipients cleared the Legislature's public health committees on Tuesday.

The payments are the first phase of an initiative, authorized by the Legislature this year under Act 775, aimed at reducing the cost of caring for certain Medicaid recipients who have expensive health needs.

Starting in February, the Medicaid program will pay companies owned by health care providers a monthly fee of $173.33 for each Medicaid recipient whose care the company is assigned to coordinate.

In a voice vote, with no members dissenting, the Legislature's House and Senate public health committees on Tuesday reviewed rules implementing that phase of the initiative.

Under the second phase of the program, which will start in 2019, the companies will take over responsibility for covering all of the recipients' health care needs in exchange for larger payments from the Medicaid program.

The state Department of Human Services has not yet published rules governing that part of the program.

Medicaid recipients who will receive the care coordination include about 22,000 Arkansans with significant mental illnesses and about 8,000 Arkansans with developmental disabilities.

The state Medicaid program, which has a budget this year of about $7.6 billion in state and federal funds, spends about $1 billion a year on medical care and other services for those recipients, Human Services Department officials have said.

Five companies, formed by coalitions of providers, have submitted letters of intent to provide the care-coordination services, according to the state Medicaid program website.

Those companies are Empower Healthcare Solutions, Arkansas Total Care, Arkansas Advanced Care, Forevercare and the Arkansas Provider Coalition.

Act 775 requires the companies to be at least 51 percent owned by health care providers and to contract with providers across the state.

Also on Tuesday, the public health committees reviewed rules requiring Medicaid recipients with significant mental illnesses and developmental disabilities to undergo assessments of their needs.

Those assessments would be conducted by Optum Government Solutions, a division of Minnetonka, Minn.-based United Health Group, under a contract calling for the company to be paid $25.5 million over two years.

The company would also screen children applying to preschool programs for the developmentally delayed.

The rules reviewed by the public health committees on Tuesday will go for approval next week to the Legislative Council's Administrative Rules and Regulations Subcommittee and the full council.

Metro on 09/06/2017

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