Proposed Improvements to Centennial Care 2.0
Date: 03/21/19
Proposed Improvements to Centennial Care 2.0
The New Mexico Human Services Department (HSD) is proposing improvements to the Centennial Care 2.0 program and is seeking input from stakeholders throughout New Mexico for consideration before submitting a final waiver amendment to the federal Centers for Medicare and Medicaid Services (CMS).
HSD has released a draft Section 1115 Demonstration Waiver amendment application for Centennial Care 2.0. The draft amendment outlines HSD’s modifications to improve the program. The draft amendment can be reviewed by clicking here. HSD is seeking federal authority to amend the 1115 Centennial Care 2.0 Waiver (Project Number 11W-00285/6) to make the following changes:
Removal of Co-payments for Centennial Care Members
As currently approved, the Centennial Care 2.0 waiver would allow co-payments of $8 for non-emergency use of the hospital Emergency Department (ED) and $8 for non-preferred prescription drugs for most Centennial Care members. HSD does not intend to implement these co-payments and seeks to remove this authority from the waiver.
Removal of Premiums for Members of the Adult Expansion Group
The current Centennial Care 2.0 waiver requires HSD to implement monthly premiums of $10 for members of the Adult Expansion Group who have income above 100% of the Federal Poverty Level (FPL), effective July 1, 2019. HSD does not intend to implement premiums and seeks to remove the requirement to implement them from the waiver.
Reinstatement of Retroactive Eligibility
The current Centennial Care 2.0 waiver includes a phase-out of the three-month retroactive Medicaid coverage period for non-pregnant adults covered under Centennial Care. In calendar year 2019, the retroactive period is limited to one month. In calendar year 2020, the waiver requires the HSD to eliminate retroactive coverage for this population completely.
HSD does not intend to proceed with eliminating retroactive coverage in 2020 and seeks federal approval to reinstate the full retroactive coverage period for all affected individuals as quickly as possible. HSD’s proposed effective date for reinstating retroactive coverage is July 1, 2019.
Community Benefit Services
Centennial Care expanded the availability of Community Benefit (CB) services to individuals who qualify for full Medicaid coverage and meet a Nursing Facility Level of Care (NF LOC) by eliminating the requirement for a waiver allocation in order to access the full suite of CB services. HSD has continued to provide access to CB for certain members who do not meet standard Medicaid financial eligibility by establishing 4,289 slots in the Centennial Care waiver. Current allocation efforts by HSD are keeping up with attrition; however, HSD anticipates that the need for additional slots will increase. HSD is proposing to increase the number of slots by 1,500 through the waiver amendment.
Home Visiting Pilot
The Centennial Care 2.0 home visiting pilot program focuses on pre-natal care, post-partum care, and early childhood development in state-designated counties. HSD is proposing to remove the restriction on the number of counties in which the home visiting project can be implemented, as well as the number of potential members who can be served by home visiting services. Additional counties providing home visiting services will be designated by HSD throughout the term of the waiver.
The public will have opportunities to provide feedback to HSD about the changes outlined in the draft application during two public hearings in April 2019, or by submitting written comments. After the hearings, HSD will develop its final waiver amendment application for submission to CMS in April 2019.
http://www.hsd.state.nm.us/approvals.aspx.
The requested changes will impact the currently approved waiver authorities, expenditure authorities and Special Terms and Conditions (STCs) for the period between January 1, 2019 and December 31, 2023. Please note that the STCs for Centennial Care 2.0 are currently being modified by CMS for technical corrections identified by HSD. Due to the status of the technical corrections, actual references to STC language are not reflected in this document; however, STC language will be made available upon request.
Follow this link to read the full article from the New Mexico Human Services Department: http://www.hsd.state.nm.us/centennial-care-2-0.aspx