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Public Notices for 1115 Demonstration Waiver Project Applications/Renewals/Amendments

State’s Public Notice and Input Processes for 1115 Demonstration Waiver Project Applications/Renewals/
Amendments

In accordance with federal and state law, the Division of Medical Services (DMS) of the Arkansas Department of Human Services (DHS) must notify the public of its intent to submit to the Centers for Medicare and Medicaid Services (CMS) any new 1115 demonstration waiver project or extension renewal or amendment to any previously approved demonstration waiver project [i.e., ARKids First-B, HIFA, TEFRA, Women's Health (family planning)] and must make available at least a 30-day public comment period at minimum 30 days prior to submitting to CMS the new 1115 demonstration waiver project or extension renewal or amendment.

Public notices, including the description of the new 1115 Demonstration Waiver project or, extension renewal or amendment to an existing demonstration waiver project to be submitted to CMS, will be posted here along with links to the full public notice and the application/extension/amendment document to be submitted to CMS.

The full public notices will include

  • the address, telephone number and internet address where copies of the new demonstration waiver project or extension or amendment document is available for public review and comment,
  • the postal address where written comments can be sent,
  • the minimum 30-day time period in which comments will be accepted,
  • the locations, dates and times of at least two public hearings convened by the State to seek input, (At least one of the two required public hearings will use telephonic and/or Web conference capabilities to ensure statewide accessibility to the public hearing.)
  • and a link to the CMS website to access comments (HTML, new window) received by CMS during their 30-day public comment period after the application/extension/amendment has been submitted to CMS.

Comments may be provided during scheduled public hearings or in writing during the public comment period. To submit comments, write to

Division of Medical Services
Program Development and Quality Assurance
P.O. Box 1437 (Slot S295)
Little Rock, Arkansas 72203-1437

Locations, dates and times for public hearings will be published below after scheduling is finalized.

If you need this material in an alternative format, such as large print, please contact the Program Development and Quality Assurance Unit at 501-320-6429.

Health Care Independence [HCIW] (aka Private Option) 1115 waiver
TEFRA Renewal
ARKids First-B Extension Renewal

Health Care Independence [HCIW] (aka Private Option) 1115 waiver

The Arkansas Department of Human Services (DHS), Division of Medical Services (DMS) is providing public notice of its intent to submit to the Centers of Medicare and Medicaid Services (CMS) a written application to request approval of a Health Care Independence 1115 Demonstration waiver and to hold public hearings to receive comments on this Demonstration.

To implement the Arkansas Health Care Independence Act, the State will use premium assistance to purchase qualified health plans (QHPs) offered in the individual market through the Marketplace for individuals eligible for expanded coverage under Title XIX of the Social Security Act who are either (1) childless adults between the ages of 19 and 65 with incomes below 138% of the federal poverty level (FPL) who are not enrolled in Medicare or (2) parents between the ages of 19 and 65 with incomes between 17 and 138% FPL who are not enrolled in Medicare (collectively "Private Option beneficiaries"). Individuals in two groups—(1) those who are medically frail or (2) other individuals with exceptional medical needs for whom coverage through the Marketplace is determined to be impractical, overly complex, or would undermine continuity or effectiveness of care—will not participate in the Demonstration.

Private Option beneficiaries will receive the Alternative Benefit Plan (ABP) through a QHP that they select and have cost sharing obligations consistent with both the State Plan and with the cost-sharing rules applicable to individuals with comparable incomes in the Marketplace.

The Demonstration will further the objectives of Title XIX by promoting continuity of coverage for individuals (and in the longer run, families), improving access to providers, smoothing the "seams" across the continuum of coverage, and furthering quality improvement and delivery system reform initiatives. Ultimately, the Demonstration will provide truly integrated coverage for low-income Arkansans, leveraging the efficiencies of the private market to improve continuity, access, and quality for Private Option beneficiaries. Additionally, by nearly doubling the size of the population enrolling in QHPs offered through the Marketplace, the Demonstration is expected to drive health care system reform and more competitive premium pricing for all individuals purchasing coverage through the Marketplace.

The Demonstration will be statewide and will operate during calendar years 2014, 2015, and 2016. The State anticipates that approximately 225,000 individuals will be eligible for the Demonstration. The State expects that, over the life of the Demonstration, covering Private Option beneficiaries will be comparable to what the costs would have been for covering the same group of Arkansas adults using traditional Medicaid.

The Demonstration will test hypotheses related to provider access, churning, emergency room use, cost-comparability, usage of Medicaid wrap benefits, quality improvement, preventive services, and uncompensated care costs.

Public comments may be submitted until midnight on July 24, 2013. Comments may be submitted by e-mail to hciw@arkansas.gov.

Document

Deadline for Submitting Written Comments

File Name

File Size

Comments, Responses, and Changes to Demonstration Waiver Application

File Size

Health Care Independence [HCIW] (aka Private Option) 1115 waiver - INITIAL DRAFT

7/24/13

InitialHCIWApp.doc

186k

View comments regarding the HCIW Waiver Application.

10MB

Health Care Independence [HCIW] (aka Private Option) 1115 waiver - FINAL

FinalHCIWApp.pdf

1MB

View summary of responses regarding the final HCIW Application.

598k

Arkansas Health Care Independence Program (“Private Option”) Proposed Evaluation for Section 1115 Demonstration Waiver - FINAL

HCIWEvalStrategy.pdf

678k

Public Hearing Transcripts for Health Care Independence [HCIW] (aka Private Option) 1115 waiver

View the public hearing presentation by Dr. Andy Allison (PDF, new window) for the proposed 1115 Health Care Independence Waiver (Private Option).

Location of Public Hearing

File Name

File Size

Little Rock

LRTranscript060213.pdf

289k

Fort Smith

FSTranscript060813.pdf

337k

Monticello

MOTranscript060913.pdf

380k

TEFRA Renewal

The DMS is providing public notice of its intent to submit to CMS a written application to request a renewal of the TEFRA-like 1115 (a) demonstration waiver project for an additional three years from January 1, 2014, through December 31, 2016. Without a renewal, the TEFRA-like demonstration project is scheduled to end on December 31, 2013.

The Arkansas TEFRA-like demonstration waiver provides services to disabled children eligible for Medicaid under section 134 of the Tax Equity and Fiscal Responsibility Act (TEFRA). TEFRA (also known as the Katie Beckett Option after the child whose plight inspired Congress to enact this option into Medicaid law) was developed to allow a child with disabilities living in a family with income that is too high to qualify for Medicaid to gain Medicaid eligibility based on the income and resources of the child by requiring a sliding-scale family premium if the family's income is greater than $25,000; and by requiring families, who have health insurance for the TEFRA eligible child, to retain that insurance. The State's goal is to continue to provide medical services to disabled children eligible for Medicaid under section 13 of the Tax Equity and Fiscal Responsibility Act (TEFRA) through the TEFRA-like 1115 demonstration waiver.

You may view TEFRA annual report files on this website.

Document

Deadline for Submitting Written Comments

File Name

File Size

Comments, Responses, and Changes to Demonstration Waiver Application

File Size

TEFRA Renewal - Supporting Documentation

7/9/13

TEFRARenewalSupportDoc.doc

55k

TEFRA Renewal - Attachment A – Notice of Intent and Public Input Hearings

7/9/13

TEFRAAttachA.doc

49k

TEFRA Renewal - Attachment B - TEFRA Budget Neutrality/Cost Savings

7/9/13

TEFRAAttachB.xls

38k

TEFRA Renewal - Attachment C – Summary of Evaluation Status

7/9/13

TEFRAAttachC.doc

34k

TEFRA Renewal - Attachment D – Compliance w/ STCs

7/9/13

TEFRAAttachD.doc

167k

CMS Incomplete Renewal Application Letter

TEFRAincompleterenewapp.pdf

145k

Summary of Public Comments and State's Responses

TEFRACommentSummary.doc

38k

Letter from CMS regarding Arkansas TEFRA 1115 Demonstration Renewal Application – Complete

LtrTEFRAcomplete.pdf

126k

Letter from CMS regarding Arkansas TEFRA 1115 Demonstration Temporary Extension until December 31, 2014

LtrTEFRAExt.pdf

70k

ARKids First-B Extension Renewal

The DMS is providing public notice of its intent to submit to CMS a written application to request an extension renewal of the ARKids First-B 1115 (a) demonstration waiver project for an additional three years from January 1, 2014, through December 31, 2017. Without an extension renewal, the ARKids First-B demonstration project is scheduled to end on December 31, 2013.

The ARKids First-B demonstration waiver provides coverage for uninsured children through age 18. ARKids First-B offers a less comprehensive benefit package than the State's traditional Medicaid program, which is referred to as ARKids First-A, and requires co-payments. The ARKids First-B demonstration waiver utilizes the same provider system as ARKids First-A and operates under a primary care case management model. The objectives of the ARKids First-B demonstration waiver are to integrate uninsured children into the health care delivery system and to provide a Secretary-approved benefit package comparable to the State Employees and State Teachers Insurance Program.

You may view ARKids First-B annual report files on this website.

Document

Deadline for Submitting Written Comments

File Name

File Size

Comments, Responses, and Changes to Demonstration Waiver Application

File Size

ARKids First-B Extension Renewal Cover Letter

12/30/12

ARKidsRenewal.doc

178k

ARKids First-B Extension Renewal Supporting Documentation

12/30/12

ARKids-B-RenewalSupportDoc.doc

45k

ARKids First-B Extension Renewal - Attachment A

12/30/12

Attachment-A.doc

208k

ARKids First-B Extension Renewal - Attachment B

12/30/12

Attachment-B.doc

33k

ARKids First-B Extension Renewal - Attachment C

12/30/12

Attachment-C.xls

37k

ARKids First-B Extension Renewal - Attachment D

12/30/12

Attachment-D.doc

22k