March Joint Medicaid Oversight Committee focuses on CVS, Caremark Business Practices

While the agenda of the March 15th Joint Medicaid Oversight Committee (JMOC) did include the regular review of the Behavioral Health Redesign, the majority of the conversation centered on Medicaid Managed Care Organizations (MCOs) and Ohio’s pharmacy benefit. As has been reported by multiple outlets, CVS and Caremark, CVS’ Pharmacy Benefit Manager (PBM), have faced significant scrutiny over the last...

Public Comments to the Ohio Department of Medicaid on the Proposed Medicaid Work Requirement Waiver

Loren Anthes, Public Policy Fellow, Medicaid Policy Center INTRODUCTION Pursuant to Ohio Revised Code §5166.37, [1] the Ohio General Assembly has mandated the Ohio Department of Medicaid seek federal approval for an 1115 Demonstration Waiver imposing work requirements on individuals covered through Medicaid via the Group VIII expansion. Pursuant to law established in the Patient Protection and Affordable Care Act, and...

County Health and Human Services Levy Headlines HHSA County Committee Meeting

At the January 17 meeting of the Health, Human Services and Aging (HHSA) Committee of the Cuyahoga County Council, the first of 2018, the committee welcomed its newest member, Michael Houser.  The HHSA Committee is now comprised of Chair, Councilwoman Yvonne Conwell, Vice Chair, Councilman Michael Houser, Councilwoman Nan Baker, Councilman Dale Miller and Councilwoman Shontel Brown. Council President Dan...

Work Requirement Waiver

BACKGROUND On February 16th, the Ohio Department of Medicaid, pursuant to Ohio Revised Code section 5166.37 established in the biennial budget of 2017, posted its proposal to implement work requirements for the Medicaid expansion population. The Department is seeking the change in policy through the vehicle of an 1115 demonstration waiver. It will serve as an additional eligibility requirement for...

94% of Providers Submitting Claims Have Had at Least One Payment, Nearly 1 in 3 Have Yet to Submit

It has now been more than six weeks since the Ohio Department of Medicaid (ODM) and the Department of Mental Health and Addiction Services (ODMHAS) launched Behavioral Health Redesign on a fee-for-service basis and via the MyCare Ohio plans. In that time, 433 unique providers have submitted claims to ODM for newly available and recoded mental health and substance use...

Ohio Benefits Pilot Update

Updated March 1, 2018 OHIO BENEFITS PILOT For the first time since 2013, three of Ohio’s core work support programs – Medicaid, Food Assistance (SNAP), and Cash Assistance (OWF) – are one step closer to being re-integrated into a single eligibility. KEY TAKEAWAYS New eligibility system being piloted in five counties will roll out to remaining 83 counties in July...

Provider Contracts Dominate Final County Council HHSA Committee Meetings

The November 16, 2017, meeting of the Cuyahoga County Health, Human Services and Aging Committee featured a list of contracts that were before the committee, as the county authorized and re-authorized contracts to begin in 2018. The testimony opened with Director Bernadette Kerrigan of First Year Cleveland and Matt Carroll, Chief Economic Opportunity and Growth officer, who discussed infant mortality....