Certainly everyone has heard that Medicare/Medicaid is having problems and it is true for the Arkansas State Medicaid program also. Presently, shortfall amounts such as $60 million next year and $230 million the year after are being given to motivate change in the way Medicaid is handled. Medicaid is trying to keep the program to less than a 5% growth rate and is making changes to make that happen. As part of that effort, Medicaid held a stakeholders meeting on May 26 to inform providers of what is coming.
Much of what was presented seemed to be a rehash of previous meetings but from different people. The discussion about “medical homes” was basically left with their intention to continue with the idea and there will be more info to come. There was an attempt to further define “episodes of care” by example which has been done before. There was more discussion on the partnerships. I think Medicaid understands that many providers services are competitive in nature and those providers will not be able to work together. One idea that was put forth was providers in rural areas of the state that could not afford the equipment and skilled persons might employ Tele-medicine to make up the shortage. Attendees were shown the ETG system used by insurance to define and predict bundles of care. That info can be used to identify which providers are not preforming at an optimal level.
The plan is to identify and prioritize the provider groups and start trying to get things moving on putting the program together in July with hopefully a working framework of some kind by December. This will give Medicaid something to show legislators that the system is being reformed. The meeting was held in the Blue Flame Room at Child Support Enforcement and due to security issues part of the presentation was unusable but a draft work-plan was handed out when the meeting was over. Meeting materials are available on the Medicaid website at: https://www.medicaid.state.ar.us/ and look for Transforming Medicaid.
WEB RA
Medicaid is not going to continue mailing Remittance Advices (RA) to providers. Providers will need to register for the WebRA starting June 6. If a provider has more than one provider number they will need to register for each number. The Web RA will be in PDF format. The Web RA will be available on the Medicaid website on Monday instead of waiting until Saturday for the regular mail copy to be delivered. To register, one must log on to the Provider section with their Medicaid ID and password (as to check a potential resident’s benefits) and click on the WebRA link. Medicaid will retain copies of the RA on their website for 35 days.
Persons who have limited or no internet access may still register as a “hardship” and get the RA mailed to them. Also, paper checks will still be mailed to those that are currently receiving them.
