This Week in Public Policy provides a summary of policy and legislation in Ohio and at the federal level that is of interest to people with disabilities.
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On Tuesday, August 21, 2018, the Ohio Department of Medicaid, the Office of Budget and Management and Governor John Kasich participated in a press conference to announce the release of a report that evaluates the Group VII Medicaid Expansion. According to the report, “The phrase ‘Group VIII’ refers to the section of the Social Security Act that sets requirements for Medicaid expansion eligibility which allowed most Ohioans age 19 through 64 with incomes at or below 138% of the federal poverty level (FPL) to become eligible for Medicaid. Prior to January 1, 2014, Medicaid eligibility for adults was limited to those with certain qualifying characteristics such as parenthood or disability, and the income limitation for most Medicaid eligibility groups was at or below 90% of the FPL.” OBM Director Tim Keen stated at the press conference that the Medicaid expansion group was fiscally sustainable, noting that the federal government picks up 90% of the cost for this group, and actual cost to Ohio is closer to 3% due to reductions in other costs. Governor Kasich added the program was only sustainable if the federal government keeps its promise to finance 90% of the cost for the expansion group.
On Tuesday, August 21, 2018, the Senate Homeland Security and Governmental Affairs Committee held a hearing entitled, “Examining CMS Efforts to Fight Medicaid Fraud and Overpayments.” In his opening statement, Chairman Ron Johnson stated the Medicaid cost per enrollee now averaged nearly $8,000 and that the total cost is $554 Billion per year. Johnson stated that overpayments to providers are roughly $37 Billion per year, a 157% increase since 2013. In her opening statement, Ranking Member Claire McCaskill reiterated the need to ensure Medicaid funds are used appropriately before making other statements related to the cost of prescription drugs under the Medicare Program.
Seema Verma, Director of the Centers for Medicare and Medicaid Services (CMS), provided testimony to the committee related to their efforts to crack down on overpayments and fraud in the Medicaid program. Verma announced that in June of 2018, CMS issued a first every Medicaid and Children Health Insurance Program (CHIP) Scorecard that includes data related to well child visits, mental health conditions, children’s preventative dental services, and other chronic health conditions. Verma outlined the agency’s approach to improving program integrity of Medicaid through specific audits of state programs.
Notable quote from Verma; “Medicaid was created to care for the nation’s most vulnerable populations – low income seniors in need, pregnant women, children, and people with disabilities. For these individuals, Medicaid is more than a safety net, it is a lifeline. One that needs to be preserved and protected for those most in need. The Patient Protection and Affordable Care Act (PPACA), however, significantly expanded Medicaid eligibility, allowing states to enroll childless, non-disabled adults with incomes below 138 percent of the poverty level.” (See Group VII in the Ohio section).
Also testify before the committee was Eugene Dodaro, Comptroller of the United States. Dodaro reviewed the findings of a GAO report that identified ways for CMS to reduce overpayments and fraud in Medicaid.
Also on Tuesday, August 21, 2018, a coalition of health and human services organizations joined forces to oppose efforts by the state of Kentucky to eliminate (waive) their Non-Emergency Medicaid Transportation coverage under the Medicaid Program.
NEXT Week in Public Policy: August 27-31, 2018
No committees scheduled.
No pertinent committees scheduled.