Health and Family Services Cabinet
1115 Waiver Will Create Sustainability for Medicaid
Frankfort, Ky. (Nov. 4, 2005) Kentucky Medicaid today submitted to the federal Centers for Medicare and Medicaid (CMS) the KyHealth Choices waiver proposal seeking the flexibility to transform Medicaid into a sustainable program that will improve the health status of members.
“This waiver will allow us the necessary flexibility to ensure that Medicaid is available to provide health care for current and future generations of Kentuckians,” said Governor Ernie Fletcher. “The Medicaid program as it exists today is simply unsustainable. We have a responsibility to take action now to preserve Medicaid and prevent it from draining available resources away from other vital areas of government, such as education.”
The first phase of the Fletcher administration's Medicaid Modernization initiative has been completed, putting into place improved infrastructure in the areas of benefit management, care management and technology. The second and final phase of the Medicaid Modernization effort will allow the state the flexibility to build on Medicaid's new capacities.
"Medicaid is a health plan serving 691,000 Kentuckians," said Shannon R. Turner, Medicaid commissioner. "In developing the waiver proposal, we have drawn from best practices in other states and the private sector to determine how we can operate the program more efficiently while continuing to provide quality care for Medicaid members."
The Department for Medicaid Services (DMS) partnered with consumers, family members, advocacy organizations and providers to develop a waiver proposal that would stretch resources to most appropriately meet the needs of members and encourage personal responsibility for health care. KyHealth Choices’ mission is to: improve the health status of those Kentuckians enrolled in the Medicaid program; ensure a continuum of care; guarantee individual choice; and to ensure the solvency of the Medicaid program in the future.
The major components of the KyHealth Choices program are:
benefit packages; cost sharing and service limitations; integrated care between physical and behavioral health services; disease management programs; and Get Healthy accounts.
KyHealth Choices will provide health care coverage for Medicaid members throughout the state, except those currently being served by Passport and ventilator-dependent individuals served under an existing waiver. Current waivers for acquired brain injury, supports for community living and home and community based services will be included in KyHealth Choices. Implementation is slated to begin in January, contingent on the federal government’s approval.
A draft of the waiver proposal can be viewed at the Medicaid home page under the announcements heading: http://www.chfs.ky.gov/dms