- Associated Press - Tuesday, November 24, 2015

LITTLE ROCK, Ark. (AP) - A legislative task force looking at the future of Arkansas’ hybrid Medicaid program is nearing a deadline for recommendations.

Health Reform Legislative Task Force Chairman Rep. Charlie Collins said Tuesday that the group needed to be ready to make a decision at its December meeting on recommendations to Gov. Asa Hutchinson for changes to the program and to overall Medicaid in the state. Department of Human Services Director John Selig said a pressing deadline is coming in the next week.

Selig said Arkansas has to file notice with the federal Centers for Medicare and Medicaid Services that it plans to amend the existing waiver that allowed the state to create the hybrid Medicaid program. He said the state has built up savings and other benefits under the existing waiver that could be lost if it chooses to end the current waiver and apply for a new one.

“Doing amendments to the existing waiver will be much more beneficial to the state than simply getting rid of it and starting all over again,” Selig said.

He urged the task force to move quickly with its recommendations because of the work that has to go into an amendment application including public hearings, actuarial studies and giving the Arkansas Insurance Department time to hash out what new contracts would look like for provider services.

Collins said the group has had fewer contentious discussions about the hybrid program than about overall Medicaid reforms.

“I feel like that is a less contentious issue than the issue of moving to a managed care versus a (patient-centered medical home) model, that’s true,” Collins said.

Collins said the task force will give recommendations on all of the things it wants to see changed in the hybrid program, which have centered on encouraging work, encouraging personal responsibility and encouraging healthy behaviors.

“There are certain things we know that (the Centers for Medicare and Medicaid Services) will not agree to, so we put those options in a second bucket, which we call the out-of-the-box solutions,” he said. “Then we would come back when we got a new administration in Washington and then ask for a work requirement and things of that nature. We can then enhance the program even more.”

The task force spent most of Tuesday’s meeting discussing how to reach the governor’s savings goals with overall Medicaid reform. Collins said he believes the group has narrowed its options to either a patient-centered medical home model or a hybrid model that also incorporates managed care for a portion of the Medicaid population.

Both Selig and Hutchinson have told the group they support managed care- hiring a private company to manage some programs- but only for high-cost populations. Collins said he has seen no support for shifting the whole system to a private company.

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