Category: Medicaid

April 30, 2018

Hungry for Policy: A Deeper Dive on Older Adults

The Center for Community Solutions Public Policy Fellow Loren Anthes recently authored an issue brief on the relationship between food insecurity and Medicaid. One of the key takeaways from the brief is that “as a social determinant of health, food insecurity increases cost and diminishes outcomes in health care.” With a high number of older...

April 23, 2018

Medicaid Work Requirement Waiver to be Submitted to Federal Government by End of April, ODM Director Informs JMOC

At the April meeting of the Joint Medicaid Oversight Committee (JMOC), the Director of the Ohio Department of Medicaid (ODM), Barbara Sears, notified committee members that her department intends to submit Ohio’s request for federal waiver authority to implement work requirements for the Medicaid expansion population by the end of this month. The Center for...

April 9, 2018

IMD waivers and the opiate epidemic: Ohio, other states and money

By: Loren Anthes, Adam White  The opiate crisis in Ohio has precipitated many policy conversations about how to curb opiate-based mortality, provide better treatment and encourage recovery. Providers, lawmakers and The Center for Community Solutions have all looked at the ways in which Medicaid policy could be leveraged to address this need. As we have...

April 5, 2018

Ohio Medicaid Funding for County Program for Children with Autism, and Other Mental Health Needs, Slated to End

In less than 100 days the Ohio Department of Medicaid (ODM) is poised to end a special funding arrangement for a 27-year-old program in Cuyahoga County called Positive Education Program (PEP) Connections. Each year, PEP Connections serves nearly 900 high-risk youth with autism, and or other intensive mental health needs who are also at risk...

March 16, 2018

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...

March 12, 2018

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...

February 21, 2018

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...

February 20, 2018

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...

November 16, 2017

Joint Medicaid Oversight Committee: Behavioral Health Redesign Beta Testing Part II

On November 16, the Joint Medicaid Oversight Committee (JMOC) met to revisit the topic of beta testing Ohio’s Behavioral Health Redesign. This time, in addition to a presentation by Medicaid Director Barbara Sears and other Kasich administration staff, JMOC heard from the Ohio Association of Health Plans (OAHP), The Ohio Council of Behavioral Health &...