Alabama wins de­lay in launch­ing Med­i­caid man­aged-care model

Modern Healthcare - - REGIONAL NEWS - —Vir­gil Dick­son

The CMS will al­low cash-strapped Alabama to post­pone its Med­i­caid pri­va­ti­za­tion and re­struc­tur­ing demon­stra­tion.

The state’s Repub­li­can gov­er­nor, Robert Bent­ley, a physi­cian, has been a pro­po­nent of the re­struc­tur­ing, cit­ing po­ten­tial sav­ings for the pro­gram. The demon­stra­tion, which will use re­gional care or­ga­ni­za­tions, was pushed back by a year to for­mally be­gin on April 1, 2017, and end on March 31, 2022.

Alabama will be­gin en­rolling ben­e­fi­cia­ries into man­aged care by Oct. 1, 2017. But first, the CMS will check that the state is ready to im­ple­ment statewide man­aged care.

Iowa’s Med­i­caid man­aged-care pro­gram has faced sig­nif­i­cant com­plaints from providers who say they’re not get­ting paid since it was launched early last year. Repub­li­can Gov. Terry Branstad con­verted the state’s tra­di­tional Med­i­caid pro­gram to a pri­vate man­aged-care model, ar­gu­ing it would cut costs. Crit­ics said im­ple­men­ta­tion of the pro­gram was rushed.

Alabama’s Sec­tion 1115 waiver pro­vides up to $748 mil­lion over five years to move the state away from tra­di­tional fee-for-ser­vice pay­ment. The state’s GOP lead­ers have re­fused to ex­pand Med­i­caid, which would cover an es­ti­mated 300,000 ad­di­tional res­i­dents and bring about $1 bil­lion a year in fed­eral fund­ing into the state.

Alabama Gov. Robert Bent­ley

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