The Texas Health and Human Services Commission (HHSC) will begin verifying the citizenship and identity of people applying for or receiving Medicaid to comply with a new federal law that takes effect July 1.
The federal Deficit Reduction Act, passed earlier this year, does not change who is eligible to receive services. But the new law does require states to verify the citizenship or immigration status of all Medicaid clients.
HHSC Executive Commissioner Albert Hawkins said Texas already has the required proof for many Medicaid clients or will be able to access the information directly. For example, children need only a birth certificate to comply. For children born in Texas, HHSC may be able to get the birth certificate electronically, and the parents will not need to provide it.
For those applying for Medicaid for their children, the state needs proof of citizenship only for the child - not for the parents. And Medicaid clients who also receive Medicare or Supplemental Security Income (SSI) will not need to provide additional documents because their citizenship was verified as part of the enrollment process for those programs.
Legal immigrants who may be eligible for Medicaid will continue to provide proof of legal status and identity as they have in the past.
Current Medicaid clients will be asked to comply with the new requirement the next time they renew their benefits. HHSC sent a letter to clients in June explaining the requirement and will send additional reminders in client renewal packets.
More information about the new law, including a list of documents that can be used to prove citizenship and identity, is available at www.hhs.state.tx.us.
Many teen workers are starting their first jobs. Congratulations! And they’re probably more focused on how to spend their paychecks than on job safety issues. If you have teens working over the summer, you should check out the safety campaign posted online by the Occupational Safety and Health Administration (OSHA) this past April. OSHA’s safety campaign was developed to help educate both teens and employers on workplace hazards and identify ways to ensure teen safety on-the-job. The Teen Summer Job Safety Campaign is a multi-year project that will focus on industries in which teens are likely to work during their high school and college years. This year targets the landscaping industry.
OSHA has published a resource kit you can download at: www.osha.gov/SLTC/teenworkers/index.html.
The Centers for Medicare and Medicaid Services (CMS) is extending the Medicare Part D prescription drug program enrollment period for Hurricane Katrina victims, according to a June 20 DADS provider letter to community services providers.
Beneficiaries who lived in “designated parishes and counties” when the hurricane hit will have until December 31, 2006, to enroll. CMS also released information for new dual eligible beneficiaries. You may download PDF copies all related letters and documents below.
Louisiana is one of a growing number of states seeking to overhaul its Medicaid system. I wrote about the subject a few days ago. (See States Take On Medicaid Reform)
Louisiana plans to propose changes designed to provide flexibility in its Medicaid program in order to treat more uninsured patients. The changes would likely increase out-of-pocket expenses for these patients.
Louisiana has a charity hospital system that treats uninsured patients, but some believe the system should be shut down. The implication seems to be that the charity hospital system is the source of the state’s problems with Medicaid, but Louisiana Health and Hospitals Secretary Fred Cerise says the issue is much deeper. From the New Orleans Times-Picayune:
Louisiana spends more money on Medicare per capita than any other state, yet achieves the poorest results. Medicare patients, primarily senior citizens and the disabled, generally are cared for in the private sector. That data suggests that true reform will require changes in private and nonprofit hospitals, not just the state-owned hospitals that rely chiefly on Medicaid dollars for the poor and uninsured.
The state would certainly benefit from a program similar to West Virginia’s “personal responsibility contracts,” which focuses on preventive care and on giving patients incentives to stay healthy.
Congress probably won’t act on Medicare legislation until after the August recess and may end up waiting until after the elections, according to The Hill.
One of the pending Medicare bills is a proposal to eliminate late fees for beneficiaries who didn’t sign up for the Medicare prescription drug plan before the May 15 deadline, which I blogged about here.
Medical News Today has a round up of news links.
In other Medicare news, an “independent expert panel” concluded that enrollment of low-income beneficiaries in the Medicare Savings Programs has been delayed because the “hard-to-reach” group is not aware of the programs, the application process is difficult, and other reasons. (See press release)
The National Academy of Social Insurance study panel recommends that the federal government work with the Social Security Administration to make the rules of eligibility for the programs simpler and implement small changes over time that will increase the federal government’s role in the programs.
You may download the report here (PDF).
In order to raise $430 million, the governor of New Jersey has proposed to tax hospitals about $1,400 a bed. Half the funds would be used to increase matching funds from the federal government under Medicaid. (Source)
Many states require providers, including nursing homes, to pay a tax or “quality assessment fee.” States use this money to obtain matching funds from the federal government under the 50/50 Medicaid match system. There is currently no provider tax assessed against nursing homes in Texas. (Source)
Medicaid is funded through a variety of ways, and the provider tax is one. For those who want to learn more about how Medicaid is funded, I recommend a 2004 report titled, The Basics: Medicaid Financing (PDF). From the section on provider taxes:
Provider taxes are a mechanism states have used to generate the state matching funds needed to receive FFP. Beginning in the mid-1980s, states began using revenues from the imposition of fees, assessments, and other taxes on health care providers to generate the state match. In 1991, Congress placed limits on the use of provider taxes by requiring that the taxes be imposed uniformly on all providers (for example, hospitals, nursing facilities, and managed care organizations) and by prohibiting providers from being “held harmless for the costs of the tax,” that is, guaranteed that a portion of the tax amount would be returned to the provider after the federal matching funds were received.
Last month I blogged about West Virginia’s proposal to implement “personal responsibility contracts” for Medicaid recipients. In essence, beneficiaries will be required to take some responsibility for their health, and those who don’t will be penalized with reduced benefits and coverage.
As controversial as they may sound, the federal government approved the state’s plan. Medicaid serves about 55 million people, and states should do all they can to prevent fraud and waste and help the most needy.
Now it appears more states are taking the initiative to reform the Medicaid system. From the Washington Post:
Kentucky is dividing its Medicaid patients into four categories, depending on their health and their age, with different benefits for each group. Most adults will face higher co-payments for medical services and new limits on prescription drugs. But patients who sign up for a “disease management” program eventually will be able to earn credits toward extra “get-healthy benefits,” such as eyeglasses or classes to quit smoking.
Florida, meanwhile, will privatize part of its Medicaid system in September…
Predictably, Republicans and Democrats disagree over how Medicaid should be reformed. Republicans tend to support budget cuts and more state control over the program, while Democrats generally support fewer cuts and more federal control. But overall, I think that encouraging beneficiaries to focus on preventive care and to seek only the care they need will save money. It’s a good policy that all states should adopt.
In April, the Centers for Medicare and Medicaid Services proposed a rule that would cut reimbursements for implanted cardiac devices by up to 30 percent in an effort to close loopholes used by specialty hospitals. (Kaiser Network)
Since the proposed rule changes, several groups have come out publicly against it. A group called AdvaMed, which represents medical device makers, says the proposal should be delayed for one year so “interested parties” can review and assess the changes. Scott Ward of Medtronic, a medical technology company, sent letters to doctors, asking them to tell CMS and Congress that the plan needs to be updated and corrected before it’s implemented. (Medical News Today)
In a letter dated June 2, the Texas Department of Aging and Disability Services (DADS) alerts Medicaid hospice providers to changes to Medicaid hospice rules, effective June 1.
Hospice providers will have to follow additional requirements in the Contracting for Community Care Services rules in Chapter 49. For example, hospices must have a contract with DADS before billing Medicaid services and a written contract with a nursing or immediate care facilities before payment is made, and individuals must elect Medicaid hospice benefits before payment is made to the hospice.
You may download the letter here.
A group of long term care providers is calling for the elimination of Medicare Part D co-payments for patients “in certain homes” who are eligible for both Medicare and Medicaid.
The National Center For Assisted Living and the American Health Care Association, which represent long term care providers, believe that beneficiaries receiving care in certain assisted living facilities and group homes who can’t afford co-payments are adversely affected. From the Senior Journal:
Under Part D, co-payments for dual eligibles are between $1 and $5 dollars per prescription. According to recent studies, the average assisted living resident needs between eight to 10 medications—about the same as nursing facility patients.
Dual eligible beneficiaries in nursing homes are exempted from making co-payments.