Selig: Working with Feds on private option waiver

On the heels of last week’s legislative session where state lawmakers approved the “private option” health insurance plan, Arkansas Medicaid leaders are already working to move the proposal forward.

The new law, known as the Health Care Independence Act, outlines the framework for allowing Arkansas to use Medicaid expansion money from the federal government to subsidize health insurance for low-income workers in a forthcoming health insurance exchange. The primary benefit of the law will be to provide uninsured citizens who earn up to 138% of the federal poverty level to obtain insurance. By some state estimates, that universe could include as many as 250,000 Arkansans.

In the last session, legislators also approved a number of Medicaid reform bills. They include:
HB 1691 – Criminal background checks for certain providers
HB 1482 – Primary Case Management pilot program
HB 1384 – Drug testing for in-home caregivers
SB 1019 – Creates a Medicaid eligibility verification system
SB 914 – Creates Office of Inspector General

John Selig, director of the Arkansas Department of Human Services, tells Talk Business Arkansas that addressing insurance carrier concerns and submitting paperwork to federal officials are two immediate steps underway in implementing the private option law.

“The first thing we’re working on is working with the Insurance Department to get good answers to questions insurance carriers have because they’re looking at whether to be part of the exchange,” Selig said.

This week, members of his staff were in Washington, D.C. meeting with Centers for Medicaid Services officials to iron out details for getting a federal waiver to implement the private option plan.

“It’s paperwork and it’s, as they say, the devil’s in the details,” Selig said. “They’ll want some specific assurances probably, they’ll want to know, ‘Exactly how is this going to work? How’s that going to work?’”

Selig said one of the primary outcomes he sees the private option addressing is mental health services for those who may be joining the new network of insurance that the Arkansas plan will structure.

“We see what happens when people don’t get good mental health services. Most adults don’t have access to them because they’re not eligible for Medicaid and they don’t have private insurance. So I think for our mental health community, the people who need behavioral health services, they’ll get help quickly and that will help all of us,” said Selig.

Selig also said the existing Medicaid program, which started the session with a shrinking $61 million budget gap, is still showing signs of fiscal improvement. He’s still waiting for third quarter numbers, but the growth rate for Medicaid is “still in the two to three percent range.”

He credits the new Payment Reform Initiative, which is seeking to bend the cost curve on Medicaid expenses by transforming the current Medicaid payment system from a “fee-for-service” model to an “episodic care” model.

In the interview, Selig discussed how his agency will continue communications with state legislators, the turning point in the legislative Medicaid debate, and how a new contract with Tom Emerick, a former Wal-Mart benefits leader, could further transform Arkansas’ Medicaid program.

Link here to an interview with Selig.