The National Association of Medicaid Directors (NAMD) urged the “supercommittee” on September 22, 2011 to relax the rules that govern how states make changes to their Medicaid programs. NAMD said the relaxed standards would produce savings for both states and the federal government. NAMD sent a letter to the members of the Joint Select Committee on Deficit Reduction urging members to consider constructive changes in the Medicaid program that will reduce costs while increasing access and improving the quality of the care provided without a negative fiscal impact on states. The National Association of Medicaid Directors (NAMD) is a bipartisan, professional, nonprofit organization of representatives of state Medicaid agencies (including the District of Columbia and the territories).

The organization said states shouldn't need waivers to move Medicaid patients into managed care. States are increasingly turning to managed care as they try to trim their budgets, but they have to shift patients into the programs in small groups and obtain multiple waivers from the federal Medicaid agency to do so.

The letter states, in part: “One of the most important changes Congress could make would be to provide states the authority to enroll any Medicaid eligible population in care management programs — either in traditional managed care or to use managed care techniques in a fee-for-service setting — without first obtaining a waiver or special permission from the Centers for Medicare and Medicaid Services (CMS). Managed care has become a dominant delivery system model in our nation. For several decades, many state Medicaid agencies have been operating successful managed care programs for a large and growing number of Medicaid enrollees. However, historically these efforts have been focused primarily on Medicaid’s least expensive populations. States also have implemented innovative care delivery and reimbursement models in their existing fee-for-service systems. A significant number of states have now expressed interest in extending and adapting the wide range of care coordination approaches to new populations, including people dually eligible for Medicare and Medicaid. This would improve care for enrollees and accelerate savings for both the Federal government and states.”

NAMD said the supercommittee should do more to let states coordinate care for people who receive both Medicare and Medicaid. The letter endorses a framework that would allow states and the federal government to share savings from the coordination effort.  Full text of the letter can be found here: http://www.namd-us.org/images/stories/namdlettertojdc092211.pdf.

Patti Cullen, CAE
952.851.2487
pcullen@careproviders.org

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