Tag: Department of Community Health

GHF comments on six-month extension of postpartum Medicaid coverage proposal

During the 2020 Georgia legislative session, House Health & Human Services Chairwoman Sharon Cooper sponsored HB 1114. The bill allows eligible mothers to receive Medicaid coverage for six months after giving birth, up from the current 60-day limit.  

Currently pregnant women and new mothers are covered by Medicaid only up to 60 days after their birth or miscarriage. Georgia has very strict Medicaid eligibility rules for Georgia parents outside of this 60-day period and Georgia has not expanded Medicaid to other low-income adults. For these reasons, many mothers who try to apply for Medicaid after the 60-day period are ineligible and become uninsured.

Georgia’s alarming maternal mortality and morbidity outcomes prompted Georgia leaders to examine the problem and propose solutions. State leaders agreed that extending Medicaid coverage from 60-days postpartum to six months for women with incomes at or below 225% of the federal poverty level (FPL) would be a step in the right direction. This move improves access and consistent care during the more of the postpartum period.

Georgia’s Department of Community Health invited public comment on the proposal from October 8, 2020 to November 9, 2020. During this comment period, individuals and organizations were able to provide their input at two public hearings or in writing.

GHF offered its qualified support of the proposal. GHF urged the state to to go further by extending coverage to twelve months. We also recommended an expansion of Medicaid to all low-income adults. Both of these moves would optimize Medicaid’s benefits and access to care for women throughout the postpartum period and beyond. You can read GHF’s full comment letter here.


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DCH Announces Medicaid Redesign Plan

On Friday, July 13 the Georgia Department of Community Health (DCH) announced plans for next steps in the “Medicaid Redesign.”  Over the past several months, DCH has convened task forces comprised of stakeholders and advocates to formally provide input into this process. At the same time, advocates have come together as the CARE-M coalition to develop recommendations based on best practices for vulnerable populations. This redesign process is separate from but parallel to the conversations currently taking place regarding whether or not to move forward with implementation of the Medicaid expansion authorized by the Affordable Care Act. Ultimately, both processes will have a big impact on coverage and access to care for health care consumers throughout Georgia.  In a press release, DCH said:

 

 

“Today, the Georgia Department of Community Health (DCH) announced that it will move forward with implementing key recommendations from its Medicaid and CHIP (Children’s Health Insurance Program) Redesign task forces and workgroups. It will not, however, pursue wholesale restructuring of Georgia’s Medicaid program at this time because of increasing uncertainty at the federal level.”

 

 

According to DCH, the changes that the state will move forward with include: 

 

    • Proceeding with at-risk managed care to serve Georgia Families members

 

    • Transitioning children in foster care to one designated vendor statewide within the new Georgia Families program

 

    • Maintaining Georgia’s current Fee-For-Service structure for ABD populations and services

 

    • Moving forward with Home and Community-based Services Rebalancing. This rebalancing will help move patients from skilled nursing facilities to home and community based services.

 

    • Begin utilizing a value-based purchasing model. Value-based purchasing will allow DCH to continuously improve the quality of care for our members while better engaging our providers and ultimately containing costs.

 

    • Creating a one-stop portal will improve accountability and efficiency. Specifically the portal will give health care providers better information about their members and their medical history, streamline their credentialing process, and present providers with a measurement of key performance metrics and allow them to monitor quality and outcomes compared to their peers.

 

    • Creating a Common Pharmacy Preferred Drug List that will simplify the program and reduce administrative burden on providers

 

The Department has committed to continuing its work with the task forces and work group through the RFP process and past the go-live date.  As members of the Children and Families Task Force and Substance Use and Mental Health Working Group, Georgians for a Healthy Future staff will continue to provide a consumer voice in these discussions and will continue to advocate for greater access to care for Georgia’s most vulnerable citizens.  For more information about the redesign process, visit http://healthyfuturega.org/issues/medicaid-and-peachcare-redesign.

 

 

 


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Jan 11, 2021
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