The deadline to submit comments to Health + Human Services (HHS) on the benchmarks and process for determining the new essential health benefits standard (EHB) is fast approaching. States will have tremendous flexibility in determining these standards. Each state will get to determine its own benchmark within certain
limits, and starting in 2014, this benchmark will apply to all new plans in the individual and small group markets and to the Medicaid benchmark plan.
Did we get your attention? Knowing how busy you all are advocating on the hill, we thought we’d prepare a brief set of comments informed by Utah experience and market characteristics. Click here for the comments. If you would like to sign on, please send an email message to judi@healthpolicyproject.org by 5:00 pm on January 31, 2012. In the subject field please write “Sign on to EHB Comments.” Feel free to adapt these comments or submit your own.
Thanks to testimony from UHPP’s own Jason Cooke and pediatrician Dr. Jennifer Brinton, Rep Ray asked the
House Government Operations Committee to hold pending the bill that would have increased Medicaid co-pays for people who smoke. In its place Rep. Ray will file a new bill that will establish the ground work for a wellness program in Medicaid to help people quit using tobacco!!
UHPP applauds Rep. Ray for his commitment to reducing tobacco use among Utahns who depend on Medicaid for their health care. Click here for UHPP’s position paper outlining the reasons why UHPP urges a “no” vote on HB 247 as it is currently written.
In a victory for Utahns who get their healthcare through Medicaid, the federal government rejected the state’s proposal to increase co-pays for adults enrolled in the program! The proposed co-pay increase from $3 to $5 was part of the Department of Health’s 1115 waiver request to implement Medicaid Reform (SB 180; 2011, Sen. Liljenquist). The decision is also a victory for health providers who treat Utahns enrolled in Medicaid. Doctors might have seen their revenues decline if patients skipped going to the doctor for needed care because of the increased cost. Fortunately, under federal rules, providers cannot deny treatment to individuals enrolled in Medicaid if they can’t pay.
The feds gave Utah the green light to move Medicaid to an accountable care model, where the state pays for quality of health care services and outcomes rather than the quantity of services provided. They also approved incentives for patients to access the right care at the right time in the right place – a critical strategy, for example, in promoting wellness, ending harmful behaviors like tobacco use, and making sure people enrolled in Medicaid go to their doctor instead of the emergency room for more of their care.
In addition to not allowing higher co-pays, the feds rejected Utah’s proposals to:
- implement an Oregon-style program of limiting services that would be covered in a year when state revenues don’t keep pace with Medicaid cost growth;
- provide a premium subsidy option allowing Utahns eligible for Medicaid to purchase insurance through the new health insurance exchanges instead of enrolling in the Medicaid program.
Friday, at the Social Services Appropriations hearing, Sen. A. Christensen questioned the Department of Health about what the savings are likely to be in light of the portions the feds rejected. Department Director Dave Patton and Deputy Director Michael Hales stated that they expect measurable savings from accountable care in the coming years. They are enthusiastic about the potential the approved waiver provisions hold. Rep. Bill Wright urged the Department to continue pressing for federal approval of the rejected waiver elements. Patton responded that the Department is continuing discussions with the federal agency through the state’s Congressional delegation.
The good news for Utah? The hard work toward accountable care can now begin in earnest.
Kudos to Rep. Dunnigan! Utah Premium Partnership (UPP) simplification will be included in his Health System Reform Amendments bill (still in the drafting phase). This important proposal will raise the UPP eligibility for adults to 200% of the Federal Poverty Level (FPL) – the same as for kids. Utah Premium Partnership is a Utah solution to helping workers with low-wages afford health insurance offered through their jobs. Read more about UPP here.
Utah’s award winning legislative website isn’t winning any awards this year! Are you frustrated? The site was privatized last year and things aren’t working. Transparency is vital to the democratic process of the legislative session. Report the problems you encounter to Drew at the Family Investment Coalition, drew@caputah.org or Lee Davidson at the Salt Lake Tribune ldavidson@sltrib.com.
Do you miss the Agendas at a Glance function? You can access it now here: http://le.utah.gov/asp/interim/glance.html.
Families USA, “the voice for health care consumers,” just wrapped up their annual conference. UHPP shares Families USA’s goal of making sure everyone has high quality affordable health care. We were there and want to share this tidbit with you:
The Supreme Court decision about the law is coming in June and there will be a lot of talk—and misinformation— about the health care law in the media. Let’s take control of the discussion and educate our friends, neighbors, and colleagues about the law. Let people know about the parts of the law that can help them right now (read about the benefits of the law here: In Utah; Preventive Care; Reel in Costs; Mental Illness; Rights for Consumers). When people experience the benefits of the law, it will be that much harder to repeal. We need to do our part to make sure that the law is correctly implemented. Health care reform passed, but we need to ensure that our representatives know that we want the law as it was intended. The health care law is for us, let’s make it be about us.
You can watch the informative and inspiring speeches from the conference here: http://www.healthaction2012.org/.
The “3rd Party” feature of myCase rolls out live on January 25th! MyCase is an important tool. It gives people real time access to their case information. It also makes DWS and e-rep more transparent. This will help consumers will know just what information DWS needs from them and should mean less errors. But, there are some real barriers for consumers when it comes to myCase. Not everyone has access to computers, and those that do might not be “computer literate,” that is, they may find it hard or intimidating to use a computer to manage their case. Because of these barriers, advocates asked DWS to build “3rd Party” access into myCase. This way, community groups, providers, and other consumer advocates can be a “3rd Party” to the case (the consumer is the 1st party, and DWS is the 2nd party). 3rd parties will be able to help people manage their cases online and provide some relief to the overworked and underfunded DWS team.
You can request training from the DWS team by emailing mycasewebmaster@utah.gov.
Even with 3rd Party access, case ownership stays with the consumer. It works like this: the 3rd party
creates their own case, the consumer gives the 3rd Party access, and then the consumer can work with their 3rd Party helper to monitor and manage their case.
IMPORTANT: To use myCase with a 3rd Party, the computer must have updated browser, and Adobe Reader is required to review certain documents in myCase. You can get these programs here:
http://www.microsoft.com/download/en/details.aspx?id=43
http://support.google.com/chrome/bin/answer.py?hl=en&answer=95346
HOW TO CREATE A 3rd PARTY CASE
The first step for the community groups, providers, and other consumer advocates that help consumers is to
create a “3rd Party Case.” There is a link on the myCase website (https://jobs.utah.gov/liferay/) under “How do you want to log in?” that reads “3rd Party Log In.”
Click there to create an account and to sign in after your account is created. Be ready to provide the
following: name, phone address, screen name, email, password, 2 security questions, and (if applicable) the organization you are with. Medical providers and child care providers will be asked to click additional boxes. These boxes provide an extra level of security for consumers. For example, child care providers will only be able to see the amount of child care credit available—no other information— in order to protect the consumer. Next you will need to agree to the stated terms and conditions. The terms and conditions are an electronic version of the 114A form currently used when assisting consumers. MyCase will then prompt you to verify the information and give you your account number.
After you have a 3rd Party account number you have to give that number to the consumer(s) you are working with so that they can grant you access to their account.
Your 3rd Party account is good for as many consumers as you are assisting. You only need one account per 3rd Party, but, everyone in an organization assisting consumers will need their own account. You cannot create one account per organization. Your final step is to add your consumers’ account numbers to your account. Log in to your 3rd Party account. You’ll see a box on the right sidebar that allows you to enter a case number for anyone who has given you access to their account.
GAINING ACCESS (COMPLICATED BUT WORTH IT!)
There’s one more step to the process (all these steps increase the level of security for the consumer). Before you can assist people, they need to approve your access into their myCase account. They sign in as they normally would and across the top will be a tab named “MyAccount.” The tab under this reads “3rd Party” with a subheading of “control who can see your case.” When a consumer clicks on that it will prompt them to enter the 3rd Party case number, to verify the name of the 3rd Party person, and agree to terms and conditions. The terms and conditions explain to the consumer that by allowing a 3rd Party to have access they are taking on the responsibility of that person’s actions, among other legal issues. Next, there will be a series of prompts to determine how much access the consumer wants the 3rd Party to have. Then, the next prompt asks how long the consumer wants to give access to that 3rd Party (maximum one year at a time) followed by what type of contact the 3rd Party is: Authorized Representative, Representative from an Organization, or an Attorney. DWS stated that this is mostly for the purposed of them understanding who is signing on as a 3rd Party. The next screen determines the level of access and reads “What type of access do you want to give this person?” The following are the options: Full, View Pending Verifications, View Notices, View all Programs, View Child Care, View Financial, View Food Stamps, View Medical, View only Special Payments. The consumer can choose more than one box. DWS staff recognizes that this is the most
confusing box of options, but given the sensitivity of the information in myCase felt it was important to protecting consumers. The consumer will then be asked to confirm the information. Once it is confirmed
the consumer will have a box on their myCase home page showing who is able to access their case with buttons easily available to edit or delete their access.
NEXT STEPS:
We are very excited about this opportunity to better serve the consumers in our state. To provide feedback to DWS on the 3rd Party access or to request training email mycasewebmaster@utah.gov
School lunch just got healthier! Thanks to the Healthy, Hunger Free Kids Act signed into law by President Obama, kids are going to start seeing more fruits and vegetables in their school meals. The new regulations by the U.S. Department of Agriculture help our kids become healthier by:
- making sure students are offered both fruits and vegetables every day of the week
- increasing offerings of whole grain-rich foods
- offering only fat-free or low-fat milk varieties;
- matching portion size to the age of the child being served
- reducing the amounts of saturated fat, trans fats and sodium
These new rules are a great step for a healthier America. To see a before and after example sample lunch menu click here. Join the Action for Health Kids and Food Research and Action Center for a webinar to learn more about the rules, timeline, and process for implementation.
Click here for webinar information.
SPEAK UP FOR BUILDING BLOCKS & INVESTMENTS IN BETTER CARE FOR MEDICAID PATIENTS!
We just learned that public testimony for Medicaid services is scheduled for the Social Services Appropriations (SSA) Subcommittee meeting on February 2nd at 8 AM (Room 30 House Bldg.). A big shout out to Kris Fawson of Legislative Coalition for People with Disabilities & Statewide Independent Living Council for her hard work and persistence on this—and to Sen. Christensen for getting it on the calendar. To make the most of this opportunity, now is the time to recruit folks and prepare BRIEF testimony—typically the SSA allows 1 or 2 minutes per person. Hot Spots this year from UHPP’s perspective:
- SB111 (Health Care Amendments for Legal Immigrant Children by Sen. L. Robles) for around $300k;
- Dental restoration for adults on Medicaid ($3 million);
- Full funding for CHIP (Children’s Health Insurance Program), our state reform
success story. - Full funding for caseload growth and provider rates, as per Gov’s budget. See our Medicaid
Budget Scorecard for details and more talk points. - For any help with framing messages, also see UHPP’s State of Utah Medicaid 2012.
UTAH’S 2012 LEGISLATIVE SESSION: JANUARY 23 – MARCH 8, 2012
Visit the legislature’s website to see the legislative schedule, and find bills and representatives and senators. www.le.utah.gov
JOINT UTAH MEDICAID PARTNERSHIP AND UTAHNS FOR SUSTAINABLE HEALTH CARE MEETINGS
Join us at the Capitol for a joint UMP/U-SHARE meeting every Wednesday 1:15-2:00 in the Olmstead room. Olmsted Room at the Capitol- Senate Building
GETTING TO THE UTAH STATE CAPITOL
Public Transportation: If you are downtown, the UTA bus is a great option to get up to the Hill. Route 500 will take you right to the East Building’s front door! The Capitol is in the Downtown Free Zone and buses run every 15 minutes. You will find the bus and Trax schedules, routes, and trip planner at their website: http://www.rideuta.com/
Driving from outside of Salt Lake: take I-15 (either north or south) to the 600 South exit and head east on 600 South. Turn left on State Street and head up the hill to the State Capitol.
Maps of the buildings are posted here.
UTAH’S 2012 LEGISLATIVE SESSION STARTS ON MONDAY, JANUARY 23, 2012
Visit the legislature’s website to see the legislative schedule, and find bills and representatives and senators.
www.le.utah.gov
JOINT UTAH MEDICAID PARTNERSHIP AND UTAHNS FOR SUSTAINABLE HEALTH CARE MEETING
Join us at the Capitol for a joint UMP/U-SHARE meeting Wednesday, January 18 10:00AM to Noon In the Olmstead room. Olmsted Room at the Capitol- Senate Building
Representatives Jim Dunnigan, Jack Draxler, and Dean Sanpei will be joining us to talk about legislative priorities for the 2012 session. Rep. Bill Wright, the new co-chair of Social Services Appropriations will also be joining us.
GETTING TO THE UTAH STATE CAPITOL
Public Transportation: If you are downtown, the UTA bus is a great option to get up to the Hill. Route 500 will take you right to the East Building’s front door! The Capitol is in the Downtown Free Zone and buses run every 15 minutes. You will find the bus and Trax schedules, routes, and trip planner at their website: http://www.rideuta.com/
Driving from outside of Salt Lake: take I-15 (either north or south) to the 600 South exit and head east on 600 South. Turn left on State Street and head up the hill to the State Capitol.
Maps of the buildings are posted here.
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