Public Comment Sought for Proposed
Amendments to
CMS Waiver Project Number (11-W-00289/5)
The Alabama Medicaid
Agency is seeking public comment on its proposed amendments to the CMS approved
1115 Waiver Project Number (11-W-00289/5). The amendment requests the following
modifications:
·
Allow
the Agency to phase-in the RCO program on a geographic basis; the phase-in is
currently planned to begin on October 1, 2017 in Regions A and C and it is
expected that RCOs will begin operations in Regions B, D, and E after October
1, 2017, but by October 1, 2018;
·
Allow
the Agency to operate only one RCO on a mandatory enrollment basis in both
urban and rural areas;
·
Clarify
that if an American Indian chooses to opt into the demonstration, that
individual will be subject to standard enrollment and disenrollment procedures
until the next open enrollment period.
·
Re-calculate
overall budget neutrality fiscal impact to incorporate the regional phase-in of
the RCO program. Calculation amendments includes:
o
Re-calculate
the “with waiver” expenditure estimates to incorporate the regional phase-in of
the RCO program as well as updated RCO capitation rate development.
o
Adjust
the Designated State Health Program (DSHP) annual limits for demonstration year
1 and demonstration year 3; the total DSHP limit remains the same.
o
Adjust
the Transition Pool annual limits; the total Transition Pool limit remains the
same;
• Adjust the DSHP metrics to account for the
phased-in approach to RCO implementation
• Provide authority for the Agency to
distribute Transition Pool payments from demonstration year 1 through
demonstration year 5, and allow unused Transition Pool funds to be carried over
to the next demonstration year;
• Clarify that federal financial
participation is available for reimbursement to RCOs from the RCO pool for
approved start-up costs incurred after January 1, 2015;
• Clarify that the Integrated Provider System
(IPS) program will be implemented on a phased-in basis, based upon when RCOs
begin operations in each RCO region;
• Modify the IPS reporting timeframes and
payment dates, and adjust the proportion of the total IPS award that is paid
based on the approval of the IPS work plan; and,
• Not require the Agency to transition the
managed care authority to a section 1932(a) state plan amendment or a 1915(b)
waiver by the end of the demonstration.
A copy of the proposed changes
can be found on the Alabama Medicaid Agency website by clicking here.
The comment
period is open until July 2, 2017. Written comments regarding the proposed
waiver are welcome and should submitted to: RCOportal@medcaid.alabama.gov or James
Hartin, Office of General Counsel, Alabama Medicaid Agency, 501 Dexter Avenue,
P.O. Box 5624, Montgomery, Alabama 36103-5624.