Wednesday July 24, 2024
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Attorney General Andy Beshear, along with a bipartisan group of 48 other state and territory attorneys general asked congress to eliminate federal restrictions that limit their states’ ability to investigate and prosecute the abuse and neglect of Medicaid beneficiaries.

The letter sent to U.S. Representatives Tim Walberg, R-Mich., and Peter Welch, D-Vt., in support of their legislation, H.R. 3891, which would expand the authority of state Medicaid Fraud Control Units (MFCUs) to detect, investigate and prosecute Medicaid patient abuse in non-institutional settings.

“Our Medicaid Fraud Control Unit works hard to protect our most vulnerable Kentuckians from fraud and abuse,” Beshear said. “Kentucky families need congress to change out-of-date laws so that my office can pursue more cases of abuse and neglect of Medicaid patients.”

Currently, Beshear’s MFCU investigates and prosecutes Medicaid provider fraud, resident abuse complaints in Medicaid-funded health care facilities and receives and reviews abuse and neglect complaints through the Elder Abuse Hotline.

In May 2017, Beshear joined with attorneys general from 36 states and the District of Columbia to send a letter, to the United States Department of Health and Human Services Secretary Tom Price. The attorneys general urged the government to expand its policy regarding the use of federal funds to investigate and prosecute Medicaid abuse and neglect cases.

The department concluded that the expanded authority would require a change in federal law that could not be done through the regulatory process. H.R. 3891 was introduced in direct response to the attorneys general letter and subsequent response from the department.

Beshear has made protecting Kentucky families one of his office’s top priorities.

Upon taking office, one of the first steps Beshear took was to expand Kentucky’s Elder Abuse Hotline to 24/7 to help ensure seniors are protected both day and night.

To report any instances of patient abuse or Medicaid fraud to the Attorney General’s Elder Abuse Hotline call, 877-ABUSE TIP.

To date, efforts by Beshear’s office through civil settlements and criminal restitution resulted in over $71 million in obligations to the state and federal Medicaid program, Medicare, Tricare, commercial payers and other entities.

The Kentucky Department for Medicaid Services announced that it will provide the public the opportunity to review and provide input on operational modifications to the 1115 Kentucky HEALTH demonstration waiver application that is currently pending approval from the Centers for Medicare and Medicaid Services (CMS).

Last year, Governor Matt Bevin, Cabinet for Health and Family Services Secretary Vickie Yates Brown Glisson, and other state health officials introduced a comprehensive plan to help put Kentuckians on a path to better health outcomes and ensure long-term sustainability of the Medicaid program, known as Kentucky HEALTH (Helping to Engage and Achieve Long Term Health). Kentucky HEALTH is an innovative approach that offers opportunities for individuals to take an active role in their health, engage in their communities, and gain skills for long-term independence and success. The demonstration waiver includes innovative delivery system reforms to expand the treatment of substance abuse, and a unique community engagement and employment initiative for Kentucky HEALTH members designed to strengthen Kentucky’s workforce and improve health and well-being.

“Since its inception, Kentucky HEALTH has been crafted in an open and transparent manner to create the best path forward for all Kentuckians,” said Secretary Glisson. “Over the course of many months, our team of dedicated state employees has worked tirelessly to plan for the successful implementation of Kentucky HEALTH. Thanks to their expertise and commitment to breaking down silos across government agencies, collaborating with local communities, and cutting through bureaucratic red tape, the Commonwealth has identified operational modifications that would support member success, community engagement growth, and administrative efficiency of the program.”

Glisson continued, “Although these revisions fall within the original waiver’s parameters, we will continue this commitment to transparency by accepting public comment on these operational modifications. We look forward to discussing these proposed changes with stakeholders, and continuing this collaborative process.”

Gov. Bevin introduced the demonstration waiver known as Kentucky HEALTH on June 22, 2016, and offered an extended public comment period, during which three public hearings were held and more than 1,400

comments were collected. This feedback from consumers, providers, advocates, and other stakeholders was reviewed and taken into consideration prior to the final proposal being submitted to CMS.

These proposed program operational modifications are a logical outgrowth of the original waiver application, and are minor revisions resulting from the Commonwealth’s ongoing program development efforts and continued negotiations with the Centers for Medicare and Medicaid Services (CMS). Although these slight modifications do not meet the standard for requiring public input as set forth at 42 CFR 431.408, the Kentucky Department for Medicaid Services will voluntarily hold open a 30-day public comment period and two public forums to gather public input on the proposed modifications.

The Commonwealth will be holding two public forums during the concurrent federal and state comment period:

FIRST PUBLIC HEARING:

  • WHO: Representatives of the Kentucky Cabinet for Health and Family Services and Governor’s Office
  • WHAT: Public Forum
  • WHEN: Friday, July 14, 2017, 10:00 AM – 12:00 PM (EST)
  • WHERE: The Center for Rural Development 2292 South Highway 27 Suite 300 Somerset, KY 42501
  • WHY: Opportunity to receive public input on the proposed operational revisions to the Commonwealth’s pending Kentucky’s Medicaid waiver. A complete draft of the Kentucky HEALTH waiver proposal and the proposed operational modifications are available for public review online at http://chfs.ky.gov/kentuckyhealth or for in-person inspection at the Cabinet for Health and Family Services, Office of the Secretary, 275 E. Main St., Frankfort, KY 40621.
  • Please Note: An interpreter for the deaf will be providing translation services at the hearing. Telephonic capabilities will be made available and posted on the Kentucky HEALTH website.

SECOND PUBLIC HEARING:

  • WHO: Representatives of the Kentucky Cabinet for Health and Family Services and Governor’s Office
  • WHAT: Public Hearing
  • WHEN: The Interim Joint Committee on Health and Welfare and Family Services meets at 10 a.m. EST, on Monday, July 17, 2017.  During this meeting, there will be a short presentation explaining the modifications to the waiver. Public comments on the waiver will be taken upon adjournment of the committee meeting.
  • WHERE: Kentucky Capitol Annex, room 129 702 Capital Avenue Frankfort, KY 40601
  • WHY: Opportunity to receive public input on the proposed operational revisions to the Commonwealth’s pending Kentucky’s Medicaid waiver.
  • Please Note: An interpreter for the deaf will be providing translation services at the hearing. Telephonic capabilities will be made available and posted on the Kentucky HEALTH website.

A complete draft of the Kentucky HEALTH waiver proposal and the proposed operational modifications are available for public review online at http://chfs.ky.gov/kentuckyhealth or for in-person inspection at the Cabinet for Health and Family Services, Office of the Secretary, 275 E. Main St., Frankfort, KY 40621.

 

CMS acknowledges completed submission of Medicaid waiver; opens thirty day federal comment period

Today, the U.S. Department of Health and Human Services acknowledged the completed submission of the Section 1115 demonstration waiver known as Kentucky HEALTH (Helping to Engage and Achieve Long Term Health).

This innovative and common sense approach waiver will put Kentuckians on a path to better health outcomes, ensure long term sustainability of the Medicaid program and familiarize members with commercial insurance and prepare them for self-sufficiency.

“We are pleased that our Kentucky HEALTH plan has achieved this important milestone and we look forward to the public input that will be received over the next thirty days,” said Gov. Matt Bevin. “Kentucky HEALTH will allow us to provide Medicaid coverage that ensures better health outcomes for Kentuckians in a fiscally responsible manner. Without it, there will be no expanded Medicaid in Kentucky, so we look forward to working with CMS to ensure this coverage continues.”

There will now be a 30-day federal comment period similar to the public comment period Kentucky recently conducted. After that time, the Medicaid statute provides full authority for the Secretary of HHS to approve the waiver at any time.

Beginning next year, Kentucky taxpayers must begin paying a portion of Medicaid expansion costs for the first time. The prior administration unilaterally implemented Medicaid expansion without a plan to pay the additional $1.2 billion in new state spending for fiscal years 2017 through 2021 necessary for the program. Kentucky HEALTH will help improve health outcomes while ensuring the long term viability of the Medicaid program.

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