The Assister Bulletin is a technical assistance resource supported by the the  Health Resources Services Administration & Health and Human Services
under Cooperative Agreement U58CS06812. This information or its content are those of the author and should not be construed as the official position or policy, nor should any endorsement be inferred by
HRSA, HHS or the US government.



~ May 25, 2018 ~

OPEN ENROLLMENT IS OVER BUT ....
MEDICAID AND CHIP ENROLLMENTS CAN OCCUR ALL YEAR!
    
 
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Top Republican lawmakers in Virginia unveiled a new budget proposal Monday that will expand Medicaid, give state workers raises and boost the state's rainy-day fund. Sen. Emmett Hanger and Del. Chris Jones said they'd hammered out a compromise spending plan they hope will have the support of a majority in both chambers of the General Assembly. The plan will face its first big hurdle Tuesday when the Senate reconvenes. Republican Senate leaders oppose Medicaid expansion and could try to block the proposed spending plan.  Associated Press 
 
A spokeswoman for Scott (Gov., VT) said he signed the bill Wednesday morning. The measure had overwhelming support in the Democratic-controlled legislature and is one of the most aggressive attempts by a state to tackle rising drug prices that critics say are crippling state finances. Its enactment also puts the Trump administration in a bind after the rollout of a highly anticipated plan for tackling rising drug costs. HHS still has to certify Vermont's program. Politico 
 
Wilkie, confirmed by the Senate for a Pentagon post last year, has led the VA in an acting capacity since March. As a former adviser to Sen. Thom Tillis (R-N.C.) and longtime Republican hand, Wilkie's path to taking the VA's permanent helm will likely be smoother than the turbulent bid of Ronny Jackson, the president's former personal physician. Jackson withdrew from consideration to lead the VA last month amid scandal over his workplace behavior. Politico  
 
Health centers and programs that provide on-site abortions, or refer women for the procedure, could lose millions of dollars in federal family-planning funds under a new plan advanced by the Trump administration Friday. The proposal targets grants given out under a program known as Title X. The agency would require a separation-both financial and physical-between the grants and any facility or program where abortions are performed, supported or referred as a method of family planning. Wall Street Journal 
 
President Trump's plan to expand access to skimpy short-term health insurance policies, as an alternative to the Affordable Care Act, would affect more people and cost the government more money than the administration estimated, an independent federal study says. The study, by Medicare's chief actuary, suggests that the new policies would appeal mainly to healthy people, including many who have had comprehensive coverage under the Affordable Care Act. The administration estimated in February that a few hundred thousand people might sign up for the "short-term, limited-duration policies," which would not have to provide the standard health benefits like preventive services, maternity care or prescription drug coverage. New York Times 
 


A Florida judge will soon decide if patients approved to use medical marijuana will be allowed to smoke it. Leon County circuit court Judge Karen Gievers heard testimony Wednesday from two women with terminal illnesses challenging the state's ban on smoking cannabis. Associated Press
 
PRETTY PLEASE!
 
Use the correct & complete CAC & NAV # on all applications!
***13 characters (FLCAC or FLNAV + A/B/C/D + 2 digit contract # + 5 digit CAC or NAV # ***
*** CAC or NAV # is issued by your employer***
 
 
IMMIGRATION AND "PUBLIC CHARGE"
 
California is poised to become the first state in the nation to offer full health coverage to undocumented adults even as the Trump administration intensifies its crackdown by separating families at the border. The proposal - which would build on Gov. Jerry Brown's 2015 decision to extend health coverage to all children, regardless of immigration status - is one of the most daring examples yet of blue-state Democrats thumbing their nose at President Donald Trump as they pursue diametrically opposed policies, whether on immigration, climate change, legalized marijuana or health care. Politico  
    
President Donald Trump on said his administration is working on a plan to withhold aid money from countries that he believes don't do enough to prevent their citizens from illegally entering the US.
"We're going to work out something where every time somebody comes in from a certain country, we're going to deduct a rather large amount of money from what we give them in aid - if we give them aid at all, which we may not give them aid at all," he said. The president assailed US laws that allowed asylum-seekers and unaccompanied minors to stay in the US pending their immigration court dates - some of whom are MS-13 members, Trump said. At one point, Trump even accused foreign nations of encouraging their nationals to illegally enter the US.

On May 9th, NACHC and several West Coast community partner agencies sponsored a webinar on the newly proposed "public charge" standards. The proposed standards this will directly affect many immigrants upon US entry and/or upon attempting to acquire permanent residency ("green card"). But be advised that there are some immigrant categories exempt from this standard. The policies now define "public charge" as any alien that has received cash or non-cash government assistance. Many mixed-status families are already choosing to disenroll from public assistance programs like Medicaid and/or CHIP. But the new standards look back 2 years! The potential financial harm extends to health centers that provide healthcare services to consumers regardless of their immigration status. You will be receiving a request shortly from FACHC for non-identifiable stories that illustrate the negative impact of this policy.   FACHC Immigration Stories

 
 
 

  

All Certified Designated Organizations in Florida should have already received an invitation to renew their CDO Agreement with CMS to provide CAC enrollment assistance. This invitation will be sent electronically to the person who signed the original agreement. If your center has not yet received it, please notify CACQuestions@cms.hhs.gov
 
The survey from the Centers for Disease Control and Prevention found that 9.1 percent of Americans were uninsured in 2017, or a little more than 29 million people. After nearly a year of Trump, that was almost the same as toward the end of the Obama administration. For perspective, the uninsured rate dropped from 16 percent since the Affordable Care Act was signed in 2010, which translates roughly to 19 million people gaining coverage.  Associated Press 
 
The ObamaCare premium wars are back. The cost of health insurance plans on the ObamaCare exchanges could jump in the coming weeks, some by double digits, inflaming the issue ahead of the midterm elections. Democrats argue the price increases are the result of what they refer to as "Republican sabotage." They contend that, since the GOP controls Congress and the White House, the price hikes are their responsibility - and that's the message they plan to take into the fall campaign.  The Hill 
 
 
The Florida Community Health Worker Coalition, working jointly with University Miami CTSI, and the Health Council of South Florida is conducting the 2018 Florida Community Health Worker Census.
Click here to take the Census.

Heart disease is the most common killer of men in the United States, and high blood pressure is one of the greatest risk factors for heart disease. Despite knowing this for some time, we have had a hard time getting patients to comply with recommendations and medications. A recent study shows that the means of communication may be as important as the message itself, maybe even more so. Also, it suggests that health care need not take place in a doctor's office - or be provided by a physician - to be effectiveNew York Times 
 

 
Wednesday, May 30th from 1:00-2:00 p.m. ET
Management of the Patient with Hypertension during Emergencies: Experience of Puerto Rico During and After Hurricane MarĂ­a (in Spanish). Hosted by the Migrant Clinicians Network, a HRSA-funded NCA.


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I have a consumer who is a 61 yr. old  female with complex medical needs. She divides her time between FL and NJ. Her income is $13K/yr and she would qualify for NJ Medicaid but she comes to FL for 6 months. Does the Marketplace have national plans?
To my knowledge, there are no national plans on the Marketplace. However, there are insurers with national networks, which could be of interest. Keep in mind though, if the consumer is eligible for Medicaid, she would NOT be eligible for APTC and would likely be priced out of the Marketplace. Furthermore, it is illegal for a consumer to have 2 subsidized programs like Medicaid and a Marketplace plan. I would check with NJ Medicaid whether their beneficiaries must live in NJ all year and, I would also check on their covering out of state healthcare services.

My consumer enrolled in a plan prior to 1/1/18 but found that she has been enrolled in a plan in the wrong county. In March, she was granted a retroactive SEP to 1/1/18 because the error was made by the Marketplace. Now she is questions being billed for the months which have already passed.
Your consumer was never enrolled in the original plan because she never made the first ("binder") payment due to the Marketplace error. When she was granted a retroactive SEP, it allowed her to enroll in a correct plan with an effective date of 1/1/18. In support of the retroactive SEP, she must pay for those months too even though they have already passed. 


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