Medicaid Expansion

The Indiana Family and Social Services Administration (FSSA) will hold a hearing on March 23, 2011 on a Medicaid State Plan Amendment (SPA) submission to the Centers for Medicare and Medicaid Services (CMS) that will add the Healthy Indiana Plan (HIP) as the benchmark benefit package for the Medicaid expansion requirements under the Accountable Care Act (PPACA).  HIP is Indiana's current Medicaid waiver program covering parents of CHIP eligible children and certain "childless adults" to 200 percent of the Federal Poverty Level (FPL).  The notice explains, "[t]his SPA submission requests an effective date of January 1, 2014 and seeks federal approval to use HIP to cover the population that will be newly eligible for Medicaid." However, there is some question as to whether Indiana's HIP program meets the requirements of the PPACA for the Medicaid expansion requirements and whether CMS will accept the program to meet the coverage requirements for the State.  If you have any questions please contact one of our health care reform lawyers:  Kristen Gentry.

Section 6411 of the Patient Protection and Affordable Care Act (PPACA) requires States to engage a Recovery Audit Contractor (RAC) that will identify Medicaid underpayments and overpayments, and recoup overpayments made under the State's Medicaid State Plan and under any waiver of the State Plan.  While the RAC program has been in existence for a few years under the Medicare program, the expansion to Medicaid comes as part of the health care reform law. 

On October 1, 2010 the Centers for Medicare and Medicaid Services published a State Medicaid Director Letter explaining the implementation of the Medicaid RAC expansion, and also noting that the Secretary of Health and Human Services has the ability to waive the RAC requirements for States in certain circumstances.  The letter states that if a State wishes to receive a variance from a RAC requirement, the State Medicaid agency must submit a letter to the Secretary requesting the variance.  In all cases, each State will be required to submit a State Plan Amendment, noting the Medicaid changes taking place due to the RAC expansion requirements. 

Click here to view the State Medicaid Director Letter containing the PPACA Medicaid changes.

If you have questions about the letter, or about other health care reform Medicaid changes, please contact Kristen L. Gentry at 317-238-6288 or kgentry@kdlegal.com, or Leigh Ann Lauth O'Neill at 317-238-6346 or loneill@kdlegal.com.

• A detailed summary of the applicable health reform law section;
• Important dates, including effective dates and compliance deadlines applicable to that section;
• Funding and grants originating under the identified section if any are currently available; and
• Links to related and useful materials such as:

                    -The health reform law provisions themselves;
                    -Certain Federal laws that are amended by the health reform law section;
                    -Federal regulations that have been published to date and certain other materials published by Federal government agencies.

Sorting through the over 490 sections of the health reform laws can be daunting! However, for many organizations, having a handle on health reform is essential to meeting compliance requirements and taking advantage of grant opportunities.  So if you are looking for a cost-effective and easy way to nail down the health reform provisions that your organization should keep an eye on, Health Reform Connect(SM) is here to help!  For instance, are you wondering what is available in the way of hospital grants or grants for doctors, or curious about what changes are in store for medical device manufacturers or tax-exempt hospitals? Want to know more about upcoming reimbursement reductions, the Medicaid expansion, or how the disproportionate share hospital payment program will be impacted?  Health Reform Connect (SM) is your solution! 

We have created an online survey where you can select the organizational types and topic categories that are of interest to you. Based on your criteria, we will search our Health Reform Connect(SM) database and let you know how many health reform law provisions are relevant to your query. You will then have the option to purchase a Provision Kit for each section matching your selected areas of interest. For each Provision Kit you purchase, you will receive email alerts for a one (1) year period, letting you know when any of your Provision Kits have been updated. Alternatively, you can simply purchase an Initial List of the health reform law sections and title names and perform your own in-depth research. All products are available on a flat-rate basis, per Initial List and/or Provision Kit - this is our way of making Health Reform Connect(SM) cost-efficient and extremely useful to you.

Please visit us at Health Reform Connect (SM) today, or contact one of our health care reform lawyers: Leigh Ann Lauth O'Neill at 317-238-6346 or loneill@kdlegal.com, or Kristen L. Gentry at 317-238-6288 or kgentry@kdlegal.com