WEST VIRGINIA MEDICAID PROGRAM 1915(b) WAIVER AMENDMENT FOR MEDICAID MANAGED CARE
TAKE NOTICE that the Department of Health and Human Resources/ Bureau for Medical Services (“Bureau”) will be submitting an amendment to the 1915(b) Mountain Health Trust (“MHT”) Waiver to the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services in order to implement proposed state fiscal year 2016 program changes. These changes, which relate to Managed Care, are being proposed in order to enable better care coordination and utilization management, and to generate cost savings to the state. These changes apply to certain groups or populations as well as services that were previously excluded or exempt from Managed Care. This Notice is intended to satisfy the requirements of all Federal Law and regulations including, but not limited to, 42 U.S.C. Section 1396a et seq. and 42 C.F.R. Section 447.205.
1.The Bureau is requesting authority for an additional service area for The Health Plan of Upper Ohio Valley to include the counties of Berkeley and McDowell.
2.The Bureau is requesting authority to deliver the Behavioral Health Benefits to MHT members through the Managed Care Organizations.
3.The Bureau is requesting the authority to serve the Patient Protection and Affordable Care Act (“ACA”) adult expansion group now covered under Section 1937 optional coverage through the MHT Managed Care Organizations.
1915(b) WAIVER AMENDMENT
The waiver amendment, if approved, will take effect beginning July 1, 2015. An aggregate cost savings of $29,580,000 in Federal and State Funds is expected from these changes for SFY 2016.
Documents detailing these proposed actions will be available for public inspection in each county office of the Department of Health and Human Resources during normal business hours, 8:30 a.m. to 4:30 p.m., beginning May 1, 2015 through May 31, 2015 and on the web at:
www.dhhr.wv.gov/bms under Public Notices.
Written comments may be sent to the West Virginia Department of Health and Human Resources, Bureau for Medical Services, 350 Capitol Street, Suite 251, Charleston, WV 25301-3706 or on the web at:
www.dhhr.wv.gov/bms under Public Notices or by email to:
[email protected]. Any written comments received will be available for review at the above address during normal business hours of 8:30 a.m. to 4:30 p.m., beginning May 1, 2015 through May 31, 2015 or on the web at www.dhhr.wv.gov/bms under Public Notices.
Int. May 1, 2015
N.R. May 1, 2015