The transfer to managed-care companies of the responsibility for providing medical care and other services to about 40,000 mentally ill or developmentally disabled Medicaid recipients will be delayed by two months, the Department of Human Services announced Friday.
The shift to managed care is the second phase of an initiative, authorized by the Legislature last year, that was aimed at reducing the cost of caring for certain Medicaid recipients who have expensive health needs.
This year, five companies, known as Provider-led Arkansas Shared Savings Entities, or PASSEs, began coordinating the recipients' care in exchange for monthly payments of $173.33 per recipient.
Under the second phase, which had been scheduled to start Jan. 1, the companies will receive larger payments in exchange for paying for all of the recipients' care, including medical expenses, counseling and help with needs such as finding housing and performing daily living tasks.
In a tweet Friday evening, the Human Services Department announced that the start date for the second phase will be delayed to March 1 to allow more time for the companies to prepare and for the department to provide information to recipients and their families.
"This allows systems to be tested, ensure that billing systems are functioning seamlessly to allow timely payments to providers, and allows more time for training and enrolling of even more providers [in] the PASSE networks," the department said in the tweet.
The department said it also will be "educating and informing providers on the benefits of joining the PASSE system" and spreading the word about the initiative through webinars, town halls and informational materials.
"Beneficiaries' services will not be interrupted or affected by this additional time in transition to Phase II of the PASSE" system, the department said.
The agency said it and the companies decided on the delay after "discussions and feedback from stakeholders."
"I think it's a good thing," said Dianne Skaggs, director of the Mental Health Council of Arkansas, which represents 12 of the state's 13 community mental health centers. "The PASSEs weren't really ready.
"They weren't ready to bill, and DHS wasn't ready to do their billing."
Jason Miller, president of the Summit Community Care PASSE, which coordinates the care for about 12,000 Medicaid recipients and was formed by more than 70 provider groups, including the community mental health centers, said his company had been preparing for the Jan. 1 start date.
"We accept the decision from DHS to push it back 60 days, and we're going to continue to work as hard for this to be successful regardless of the date," he said.
The managed-care companies are required to be at least 51 percent owned by health care providers and to contract with providers across the state.
According to information submitted to the state House and Senate public health committees last month, the initiative had been expected to reduce state and federal Medicaid spending on the recipients, which now totals about $1 billion a year, by about $47 million next year.
Paula Stone, deputy director of the Department of Human Services' Medical Services Division, told lawmakers at the meeting that the bulk of the savings would come from keeping recipients out of "high-cost settings" such as hospital emergency rooms and psychiatric wards.
Through its insurance premium tax, the state also will be able to recoup 2.5 percent of the payments to the companies. That will generate revenue for the state because 70 percent of the funding for the payments to the companies would come from federal Medicaid funds, but the state will keep all of the premium tax.
The tax had been forecast to generate an estimated $23.1 million next year if the initiative had started in January. Half the revenue will go toward reducing the number of Arkansans with developmental disabilities who are on a waiting list for home-based services, such as help with daily living tasks. About 2,900 people were on the list as of last December.
Metro on 11/18/2018