FEDERAL (Accurate as of 12/09/2019)
Although the 2020 Fiscal Year began on October 1, 2019, Congress did not complete its appropriations process. The federal government has been operating under a continuing resolution (CR) 2019 level funding, which is set to expire on December 20. To avoid a government shutdown, one of two things must happen: Either Congress must agree to, and the President sign, another CR before the deadline. Alternately, Congress could complete its appropriations process by the 20th. Few working days remain before the deadline.
Money Follows the Person
With funding set to expire on December 31, Money Follows the Person (MFP) received a bipartisan boost in the Senate with an agreement to tie permanent funding to the Drug Pricing and Health Care Extenders package. MFP, a highly successful federally funded grant program, helps individuals with disabilities and elders move out of institutional settings into the community with supports and services. A vote in Congress is anticipated soon.
On December 4, President Trump issued a final rule which reduces eligibility for the Supplemental Nutrition and Assistance Program (SNAP), often referred to as food stamps. The administration estimates this change could lead to 700,000 people losing food benefits. In addition to limiting states’ abilities to broaden and extend eligibility, this rule creates a number of work requirements. While the work requirement changes are designed for “able-bodied adults,” previous work requirement implementations at the state level have shown that defining, identifying, and certifying individuals with intellectual or physical disabilities has proven difficult, often resulting in benefit loss.
NC Congressional Districts
On December 2, a three-judge panel ruled that the newly drawn Congressional districts which passed the state legislature in November are constitutional and will stand for the upcoming 2020 election. North Carolina will need to revise its districts yet again for the 2022 election based on upcoming 2020 census response. It’s projected that North Carolina could gain an additional seat in Congress based on that population-based allocation.
STATE(Accurate as of 12/09/2019)
The state continues to operate under last year’s budget. The legislature reconvened on November 13th with a focus on Congressional redistricting and will reconvene in January (which is a continuation of the long session which began last January). It is uncertain whether the budget will be addressed in January. The coming year is a short session which usually begins in May and is usually focused on making adjustments to the biennial budget approved the previous year. Without an approved budget and with elections coming in November, it may be an unusual short session.
Without a budget, Medicaid transformation has been put on hold since funds needed to move through transformation are not currently available. The Standard Plan was slated to go live on February 1, 2020. The Department of Health and Human Services (DHHS) has stated that they will not announce another ‘go live’ date until the funds needed have been appropriated.
With suspension, there are certain activities that have been terminated, some that will wind down, and others that will continue.
Activities that have stopped include: Counseling about which plan to choose, enrollment events, and outreach specialists located in DSS offices.
The Enrollment Broker Call Center closed on December 13, but the Medicaid Call Center and the PHP call centers will continue to operate.
At the recent i2i Conference in Pinehurst, the message from DHHS was that managed care will happen – the question is not ‘if’ but ‘when’ - and that some activities should continue. Beneficiary education will continue to ensure that there is a clear message on what to do now and what to do when managed care restarts. Providers are encouraged to continue to work on contracts with the PHPs. The PHPs will continue to engage in readiness activities. DHHS will move forward with the Ombudsman contract and with the Healthy Opportunities Pilots.
The Tailored Plan Request for Applications (RFA) is planned to be released in February 2020 as originally scheduled. The actual implementation may be affected by the suspension of the Standard Plan since the design was for the Tailored Plan to begin a year after the Standard Plan.
For now, Medicaid beneficiaries will continue to receive medical and behavioral health services as they have in the past with no changes. For those who had chosen a plan, they will be given an opportunity to affirm their choice or make a change when Medicaid transformation restarts. DHHS has set up a website with answers to frequently asked questions as well as a ‘chat’ function to address questions/concerns from consumers. http://ncmedicaidplans.gov/learn/get-answers