State Officials Anxious for Word on Medicaid Waiver

At the bimonthly stakeholders’ meeting for the Medicaid waiver yesterday, all eyes turned to the front of the room, where David Maxwell-Jolly was about to speak.

Maxwell-Jolly is the director of the state Department of Health Care Services, and he had just been asked about the status of negotiations with CMS over California’s $10 billion Medicaid waiver. The state, facing a deadline of Oct. 31 to come to final agreement on the waiver, is stuck in idle until the federal agency comes up with a draft of what it likes and doesn’t like about California’s plan.

“We don’t have a draft at this point.” Maxwell-Jolly said. “Any day now, we should be getting it.”

There are not a lot of days left. Once word from CMS arrives, state officials can begin final stages of what are already protracted negotiations of the complicated blueprint for subsidized health care implementation in California. If there are a lot of proposed federal changes to the waiver, the end-of-October deadline could get really tight.

“I think we can do it,” Maxwell-Jolly said. “We’re not clear on what the fundamental bones of contention will be. But we will very shortly. And I think there’s time to get closure on it.”

At yesterday’s meeting in the Sacramento Convention Center, health care organization representatives from all over the state gathered in a conference room to chart the progress of some of the details of the waiver, and to brainstorm about the potential paths and pitfalls of implementing the waiver.

One piece of news stood out: The California Children’s Services department had sent out a request for applications to gauge interest in setting up four different types of pilot specialty plans, from a managed care model to an accountable care organization model.

The response was heartening, according to Luis Rico, acting chief of the Children’s Medical Services Branch of the Department of Health Care Services.

“I would have been happy with two proposals for each model of care,” Rico said. Instead, he received anywhere from six to 10 proposals for each model, from 14 different organizations.

“This demonstrates interest in the pilot program by qualified applicants,” Rico said. “Now, these are just letters of intent, but still, we’re really happy about the response.”

The possibility of staggering submissions of the four different types of pilot specialty plans was raised at the mjeeting, but that idea was rejected as confusing and unnecessarily complicated. The final proposals will be submitted at the same time, most likely in February.

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