Below is the HillCo client report from the October 23 State Managed Care Advisory Committee meeting.
The 31 recommendations were discussed by the members of the committee and non-substantive tweaks and some amendments were made to the language.
- ME1 strike “in person” and replace “and” with “or”
- ME2 adopted
- ME3 adopted
- ME4 adopted
- ME 5 – add language that indicates that a “phone tree must be made easily accessible to MCO case managers”
- ME6 – change language to reflect support of “robustly staffing the current ombudsman office and building upon that to create a highly integrated network”
- ME7 – add language to “coordinate with current HIE efforts across the state for medical and dental records” and to do a “study while HHSC continues to work to implement their one claims portal”
- ME8 – adopted
- ME9 – adopted
- ME10 – amended for HHSC to conduct a study to verify the need for attendant wage increases quantitatively when compared to the lowered rate of PPRs and PPEs
- NA1 – adopted
- NA2 – adopted
- NA3 – withdrawn
- NA4 – withdrawn
- NA5 – adopted
- NA6 – replace “MCO” with HHSC, remove all references to “networks” and replace “immediate” with “predetermined basis”
- PE1 – adopted
- PE2 – withdrawn
- PE3 – withdrawn
- PE4 – adopted
- PE5 – add amendment recognizing that MCOs receive retrospective rate changes; add language that requires MCOs to make payments within 95 days of rate increase
- PE6 – withdrawn
- PE7 – adopted
- PE8 – adopted
- PE9 – adopted
- PE10 – adopted
- PE11 – adopted
- PE12 – adopted
- PE13 – amend language to say “HHSC will develop appropriate guidelines for PA services under Medicaid when the client also has other insurance coverage”
- PE14 – adopted
- PE15 – “MCOs should continue to…”
A motion was passed that allows for HHSC to make non-substantive changes to the report and recommendations based on today’s discussion. The committee adopted the following changes to the report:
- Add “home and community based service providers” to line 10, page 11
- Addition of a one page high level summary of the most common themes of the 31 recommendations
- In the subheading “Medicaid in Texas” on page 8, HHSC will get the most current and valid data to substitute for the current language in the document
The next meeting of the State Managed Care Advisory Committee will be in June, 2015.