View Article

01
posted on August 01, 2018 13:52
The Idaho Department of Health and Welfare will be collecting public comments through Aug. 22, 2018 on proposed rulemaking updating the Medicaid Basic Plan benefits paraprofessional definition for school-based services and will be holding public hearings in Boise (Aug. 14), Idaho Falls (Aug. 15) and Lewiston (Aug. 16) on proposed rulemaking for Medicaid managed care for high-cost populations, including dual-eligible Medicaid and Medicare individuals.

More information on each docket is provided in the links below:

Docket 16-0309-1809 Medicaid Basic Plan Benefits: Rules Governing Uniformity, IDAPA 08.02.02, updated the paraprofessional definition, and included language that stated that individuals not meeting the outlined requirements, would be considered a school or classroom aide. This change impacted school professionals by requiring a higher credential to provide services in school settings than is required for providers of the same service outside of the school setting (in the community). PCS paraprofessional provider qualifications are being updated for school-based services to align with community paraprofessional PCS provider qualifications.

Docket 16-0310-1801 Medicaid Enhanced Plan Benefits: Idaho House Bill 260 (2011) included legislative direction for the department to develop a plan for Medicaid managed care for high-cost populations, including dual eligibles. Idaho Medicaid has offered a voluntary,
integrated Medicare-Medicaid Coordinated Plan (MMCP) to Idaho’s dual eligibles since 2014. With the addition of another health plan to the market, dual eligibles will have two health plans to select from for the MMCP. This rule change is needed to allow Medicaid to enroll those dual eligibles who have not elected to enroll in the coordinated MMCP into a Medicaid Managed Long-Term Services and Supports program, which will administer and coordinate Medicaid benefits. (NOTE: Medicaid will concurrently seek 1915(b) Waiver authority from the Centers for Medicare and Medicaid Services (CMS) to develop a mandatory enrollment structure.) This rule change adds a new section of rules to this chapter that includes language pertaining to Idaho’s existing managed care structures (behavioral health benefits and dental benefits, respectively). The new section will also indicate that dual eligibles (except for Tribal members and other populations exempt under federal requirements) will be mandatorily enrolled into a Medicaid Managed Long-Term Services and Supports plan that will administer and coordinate their Medicaid benefits in counties where there are two or more participating health plans. Participants will have an election period during which they can select the plan of their choice. Individuals that have not selected a plan by a specified deadline will be randomly assigned to one plan or the other by the Division of Medicaid.