Medicaid comprehensive waiver application approved

TRENTON – State Street Wire has learned that the state’s application for the Medicaid Global Waiver has been approved by the federal government.

Republican presidential candidate Mitt Romney has strongly supported the waiver, as he said in last night’s debate states should have a greater say.

Human Services Department spokesman Nicole Brossoie confirmed, upon inquiries from State Street Wire, that the application was approved.

New Jersey, among other states, has applied for such waivers to help control costs. In the 2012 fiscal year, the state was facing a $1.3 billion Medicaid shortfall.

It wasn’t immediately known how big a deficit the state was facing for the 2013 fiscal year.

Medicaid, the federal program that helps provide health insurance to poor people, is jointly funded by the state and federal government.

Administration officials said the Comprehensive Medicaid Waiver would:

*streamline the program by consolidating multiple waivers across state government;

*maximize federal reimbursement for programs currently funded by state-only dollars; and

*advance the state’s efforts to redirect care for seniors and individuals with disabilities to the community, rather than to institutions. The Centers for Medicare and Medicaid Services (CMS) also approved the state’s request to deliver behavioral health services through an Administrative Services Organization, officials said. 

CMS did deny certain reform proposals outlined in the application including: New Jersey’s request to no longer provide retroactive Medicaid eligibility for applicants; consolidation of all nine state waivers into one, and the state’s appeal for an estimated $107 million in Medicare Part B retro payment for Medicare services erroneously billed to Medicaid. The federal government also determined that approval of future programmatic changes and that the Community Care Waiver will remain outside the comprehensive waiver.
The waiver will enable the state to move funding from the current Hospital Relief Subsidy Fund to an Incentive Payment model. By doing so, officials hope that it will increase competition, the quality of care, and lower costs through greater efficiency. Under the new performance-based reforms to the funding pool, federal funding levels for state hospitals will be secured moving forward, and hospitals will compete for funding based on their strengths in delivery of care.

“Our goal to preserve federal matching dollars for New Jersey’s hospitals will be achieved by reforming certain subsidy programs to incentivize quality improvement. This reform provides an opportunity to align hospital’s planning efforts and service delivery models with important public health needs of the community,” Health Commissioner Mary E. O’Dowd said in a statement. “We will continue to partner with hospitals in the implementation of these changes.”

Another emphasis in the waiver involved increasing community-based services for children who are dually diagnosed with developmental disabilities and mental illness by providing case management, individual supports and respite for caregivers.

“Through this waiver, New Jersey has built upon the success of the State’s child behavioral health system of care to improve efficiencies and increase access to behavioral health services for children throughout the State,” said Department of Children and Families Commissioner Allison Blake. “In addition, we were successful in obtaining approvals that will result in increased services for children with intellectual and developmental disabilities.”

Medicaid comprehensive waiver application approved