By Melissa Patrick
Kentucky Health News
As the Cabinet for Health and Family Services scrambles to deal with the fall-out from a court ruling that vacated the state's new Medicaid plan, which was set to go into place Sunday, July 1, its call centers and front-line staff are using a new question-and-answer document to help health-care providers advise their Medicaid clients.
The document says Kentucky HEALTH (for "Helping to Engage and Achieve Long Term Health") hasn't been cancelled, but instead has been "halted for further review" by the federal government.
The state and federal government are expected to appeal the decision of U.S. District Judge James Boasberg of Washington, D.C. Gov. Matt Bevin has said the issue will ultimately be decided by the Supreme Court.
The state has also posted a Kentucky HEALTH update on it's website, and the Q&A document says it will be sending additional information about the changes this week.
In the meantime, most of the 1.4 million Medicaid member's benefits will stay about the same as they have been for now -- no premiums, no deductibles, no reporting requirements and no requirements for work or other "community engagement." The Q&A says that managed care organizations will be charging co-payments for services.
The only exception are the 460,000 members who had been moved to a My Rewards Account who have lost their dental and vision benefits.
"When Kentucky HEALTH was invalidated by the court, the My Rewards program was eliminated, and there is no longer a funding mechanism in place to pay for dental and vision services," the health cabinet said in a statement.
The Q&A says that while members cannot use the benefits that may have already earned in their My Rewards accounts, they can still continue to earn these "virtual" dollars for qualifying activities if they so choose.
The Q&A offers answers about many topics and concerns, including, but not limited to, questions about whether a person on Medicaid can still go to the doctor to what to do about premiums, co-payments and the previously required "community engagement" or work requirements.
For example, to the question of "Will I be reimbursed if I've already made a premium payment: Will you be sending a refund?" the answer is that they are still working on how to manage this, and hope to have an update soon to share with these members. At this time, no premiums are due.
The Q&A also states that all managed care organizations will be required to pay a co-payment for their services, writing that, "The requirement to make co-payments was a state change that was separate from Kentucky HEALTH."
The document offers a list of 18 services that require co-payments. A few examples include: office visits have a $3.00 co-pay; preferred and non-preferred generic drugs have a $1.00 co-payment; preferred brand name drugs that don't have a generic equivalent have a $4.00 co-payment; and emergency room visits for non-emergency visits have an $8.00 co-payment.
It also assures Medicaid members that they can use their Kentucky HEALTH ID card for care.
The cabinet continues to stress in this document that the supports and resources in Kentucky HEALTH to help Kentuckians improve their income and health are still available and that members can still log on to www.CitizenConnect.ky.gov to take free online courses about health, life and work skills. It also encourages interested Kentuckians to visit www.KCC.ky.gov to find their local career center.
Kentucky HEALTH included, among other things, requirements for work, volunteering, job training or drug treatment; monthly reporting; lock-out periods for failure to comply; and premiums and co-payments based on income.
County totals of people on Medicaid, the expansion and other categories is at http://www.uky.edu/comminfostudies/irjci/MedicaidenrollmentbycountyJune%202017.xlsx.
Kentucky Health News
As the Cabinet for Health and Family Services scrambles to deal with the fall-out from a court ruling that vacated the state's new Medicaid plan, which was set to go into place Sunday, July 1, its call centers and front-line staff are using a new question-and-answer document to help health-care providers advise their Medicaid clients.
The document says Kentucky HEALTH (for "Helping to Engage and Achieve Long Term Health") hasn't been cancelled, but instead has been "halted for further review" by the federal government.The state and federal government are expected to appeal the decision of U.S. District Judge James Boasberg of Washington, D.C. Gov. Matt Bevin has said the issue will ultimately be decided by the Supreme Court.
The state has also posted a Kentucky HEALTH update on it's website, and the Q&A document says it will be sending additional information about the changes this week.
In the meantime, most of the 1.4 million Medicaid member's benefits will stay about the same as they have been for now -- no premiums, no deductibles, no reporting requirements and no requirements for work or other "community engagement." The Q&A says that managed care organizations will be charging co-payments for services.
The only exception are the 460,000 members who had been moved to a My Rewards Account who have lost their dental and vision benefits.
"When Kentucky HEALTH was invalidated by the court, the My Rewards program was eliminated, and there is no longer a funding mechanism in place to pay for dental and vision services," the health cabinet said in a statement.
The Q&A says that while members cannot use the benefits that may have already earned in their My Rewards accounts, they can still continue to earn these "virtual" dollars for qualifying activities if they so choose.
The Q&A offers answers about many topics and concerns, including, but not limited to, questions about whether a person on Medicaid can still go to the doctor to what to do about premiums, co-payments and the previously required "community engagement" or work requirements.
For example, to the question of "Will I be reimbursed if I've already made a premium payment: Will you be sending a refund?" the answer is that they are still working on how to manage this, and hope to have an update soon to share with these members. At this time, no premiums are due.
The Q&A also states that all managed care organizations will be required to pay a co-payment for their services, writing that, "The requirement to make co-payments was a state change that was separate from Kentucky HEALTH."
The document offers a list of 18 services that require co-payments. A few examples include: office visits have a $3.00 co-pay; preferred and non-preferred generic drugs have a $1.00 co-payment; preferred brand name drugs that don't have a generic equivalent have a $4.00 co-payment; and emergency room visits for non-emergency visits have an $8.00 co-payment.
It also assures Medicaid members that they can use their Kentucky HEALTH ID card for care.
The cabinet continues to stress in this document that the supports and resources in Kentucky HEALTH to help Kentuckians improve their income and health are still available and that members can still log on to www.CitizenConnect.ky.gov to take free online courses about health, life and work skills. It also encourages interested Kentuckians to visit www.KCC.ky.gov to find their local career center.
Kentucky HEALTH included, among other things, requirements for work, volunteering, job training or drug treatment; monthly reporting; lock-out periods for failure to comply; and premiums and co-payments based on income.
County totals of people on Medicaid, the expansion and other categories is at http://www.uky.edu/comminfostudies/irjci/MedicaidenrollmentbycountyJune%202017.xlsx.
from Kentucky Health News https://ift.tt/2MGqbsk Blocked from starting new Medicaid plan, state comes up with a question-and-answer sheet to help providers and their patientsHealthy Care
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