New and Pending Demonstration Project Proposals Submitted Pursuant to Section 1115(a) of the Social Security Act: January 1995
Federal RegisterMar 30, 1995
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[ORD-073-N]
New and Pending Demonstration Project Proposals Submitted
Pursuant to Section 1115(a) of the Social Security Act: January 1995
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Notice.
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SUMMARY: This notice lists new proposals for demonstration projects
submitted to the Department of Health and Human Services during the
month of January 1995 under the authority of section 1115 of the Social
Security Act. This notice also lists approved, disapproved and pending
proposals.
Comments: We will accept written comments on these proposals. We will,
if feasible, acknowledge receipt of all comments, but we will not
provide written responses to comments. We will, however, neither
approve nor disapprove any new proposal for at least 30 days after the
date of this notice to allow time to receive and consider comments.
Direct comments as indicated below.
ADDRESSES: Mail correspondence to: Susan Anderson, Office of Research
and Demonstrations, Health Care Financing Administration, 2230 Oak
Meadows, 6325 Security Boulevard, Baltimore, MD 21207.
FOR FURTHER INFORMATION CONTACT:
Susan Anderson, (410) 966-3996.
SUPPLEMENTARY INFORMATION:
I. Background
Under Section 1115 of the Social Security Act (the Act), the
Department of Health and Human Services (HHS) may consider and approve
research and demonstration proposals with a broad range of policy
objectives. These demonstrations can lead to improvements in achieving
the purposes of the Act.
In exercising her discretionary authority, the Secretary has
developed a number of policies and procedures for reviewing proposals.
On September 27, 1994, we published a notice in the Federal Register
(59 FR 49249) that specified (1) the principles that we ordinarily will
consider when approving or disapproving demonstration projects under
the authority in section 1115(a) of the Act; (2) the procedures we
expect States to use in involving the public in the development of
proposed demonstration projects under section 1115; and (3) the
procedures we ordinarily will follow in reviewing demonstration
proposals. We are committed to a thorough and expeditious review of
State requests to conduct such demonstrations.
II. Listing of New and Pending Proposals for the Month of January 1995
As part of our procedures, we are publishing a monthly notice in
the Federal Register of all new submissions, pending proposals,
approvals, and disapprovals. Proposals submitted in response to a grant
solicitation or other competitive process will be reported as received
during the month that such grant or bid is awarded, so as to prevent
interference with the awards process. We have added a new category in
this notice entitled ``Approved Grant Proposals'' to identify grant and
cooperative agreement awards for development of demonstration projects
that may involve section 1115 authority.
A. Comprehensive Health Reform Programs
1. New Proposals
Demonstration Title/State: Louisiana Health Access--Louisiana.
Description: Louisiana proposes to implement a fully capitated
statewide managed care program. A basic benefit package and a
behavioral health and pharmacy wrap-around would be administered
through the managed care plans. The State intends to expand eligibility
of persons with incomes up to 250 percent of the Federal poverty level
(FPL), with persons with incomes above 133 percent of the FPL paying
all or a portion of premiums. To fund the demonstration, the State is
seeking a waiver of Federal Medical Assistance Payments (FMAP)
requirements, which would effectively create a block grant whereby the
Federal share of the demonstration would be fixed over the course of
the demonstration and the State would assume the cost of increases as
they occurred.
Date Received: January 3, 1995.
State Contact: Carolyn Maggio, Executive Director, Bureau of
Research and Development, Louisiana Department of Health and Hospitals,
Post Office 2870, Baton Rouge, Louisiana 70821-2871, (504) 342-2964.
Federal Project Officer: Gina Clemons, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: SoonerCare--Oklahoma.
Description: Oklahoma proposes to implement a 5-year statewide
managed care demonstration using both fully and partially capitated
delivery systems. The emphasis of the program is to address access
problems in rural areas by encouraging the development of rural-based
managed care initiatives. The State will employ traditional fully
capitated managed care delivery models for urban areas and will
introduce a series of partial capitation models in the rural areas of
the State. All currently eligible, non-institutionalized individuals
will be enrolled during the first two years of the project.
Date Received: January 6, 1995.
State Contact: Dr. Garth Splinter, Oklahoma Health Care Authority,
Lincoln Plaza, 4545 N. Lincoln Blvd., Suite 124, Oklahoma City,
Oklahoma 73105.
Federal Project Officer: Helaine I. Fingold, Health Care Financing
[[Page 16482]] Administration, Office of Research and Demonstrations,
2302 Oak Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
2. Pending Proposals:
Demonstration Title/State: The Diamond State Health Plan--Delaware.
Description: Delaware proposes to expand eligibility for Medicaid
to persons with incomes up to 100 percent of the Federal poverty level
and require that the Medicaid population enroll in managed care
delivery systems. The State's current section 1115 demonstration
project, the Delaware Health Care Partnership for Children, would be
incorporated into the statewide program as an optional provider for
eligible children.
Date Received: July 29, 1994.
State Contact: Kay Holmes, DSHP Coordinator, DHSS Medicaid Unit,
Biggs Building, P.O. Box 906, New Castle, Delaware 19720, (302) 577-
4900.
Federal Project Officer: Rosana Hernandez, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: MediPlan Plus--Illinois.
Description: Illinois seeks to develop a managed care delivery
system using a series of networks, either local or statewide, to tailor
its Medicaid delivery system to the needs of local urban neighborhoods
or large rural areas.
Date Received: September 15, 1994.
State Contact: Tom Toberman, Manager, Federal/State Monitoring, 201
South Grand Avenue East, Springfield, Illinois 62763, (217) 782-2570.
Federal Project Officer: Gina Clemons, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: MassHealth--Massachusetts.
Description: Massachusetts proposes a range of strategies that
would extend Medicaid coverage to its low-income and uninsured
citizens, including the employed, the short-term unemployed, and the
long-term unemployed. The proposed program would employ direct
provision of health services as well as indirect strategies that would
promote market forces to address the needs of the uninsured, by
providing subsidies to employers and low-income employees with incomes
up to 200 percent of the Federal poverty level.
Date Received: April 15, 1994.
State Contact: Laurie Burgess, Director, Managed Care Program
Development, Division of Medical Assistance, 600 Washington Street,
Boston, Massachusetts 02111, (617) 348-5695.
Federal Project Officer: Ed Hutton, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: MinnesotaCare--Minnesota.
Description: Minnesota proposes to expand its use of managed care
service delivery and to extend Medicaid eligibility to families and
children with incomes up to 275 percent of the Federal poverty level.
The State would also integrate Medicaid with other public entities that
deliver health services.
Date Received: July 28, 1994.
State Contact: Maria Gomez, Commissioner, Health Care Services
Delivery, Minnesota Department of Human Services, 444 Lafayette Road N,
St. Paul, Minnesota 55155, (612) 297-4113.
Federal Project Officer: Penny Pine, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Missouri.
Description: Missouri proposes to require that beneficiaries enroll
in managed care delivery systems, and extend Medicaid eligibility to
persons with incomes below 200 percent of the Federal poverty level. As
part of the program, Missouri would create a fully capitated managed
care pilot program to serve non-institutionalized persons with
permanent disabilities on a voluntary basis.
Date Received: June 30, 1994.
State Contact: Donna Checkett, Director, Division of Medical
Services, Missouri Department of Social Services, P.O. Box 6500,
Jefferson City, Missouri 65102-6500, (314) 751-6922.
Federal Project Officer: Suzanne Rotwein, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: The Granite State Partnership for Access
and Affordability in Health Care--New Hampshire.
Description: New Hampshire proposes to extend Medicaid eligibility
to adults with incomes below the AFDC cash standard and to create a
public insurance product for low income workers. The State also seeks
to implement a number of pilot initiatives to help redesign its health
care delivery system.
Date Received: June 14, 1994.
State Contact: Barry Bodell, New Hampshire Department of Health and
Human Services, Office of the Commissioner, 6 Hazen Drive, Concord, New
Hampshire 03301-6505, (603) 271-4332.
Federal Project Officer: Maria Boulmetis, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
3. Approved Conceptual Proposals (Award of Waivers Pending)
No conceptual proposals were approved during the month of January.
4. Approved Grant Proposals (Award of Waivers Pending)
No grant proposals were awarded in the month of January. The
following are proposals awarded since January 1, 1993:
Demonstration Title/State: MAINE-NET: Medicaid and Medicare Managed
Care for the Elderly and Physically Disabled in Maine--Maine.
Description: This project is designed to demonstrate integrated
models for the financing and delivery of managed health care and social
services for elderly and physically disabled persons on Medicare and/or
Medicaid in Maine. The project seeks to promote the development of
regional service delivery networks or health plans, particularly in
rural areas of the State, that would be responsible for the management,
coordination and integration of services, including multi-disciplinary
approaches to care planning and service delivery. The demonstration
will provide a comprehensive package of primary, acute, and long term
care (institutional and noninstitutional) services as part of a prepaid
capitated health plan for the target populations. The project is in the
early developmental stage.
Date Received: March 25, 1994.
State Contact: Carreen Wright, State of Maine Department of Human
Services, State House Station #11, Augusta, Maine 04333.
Federal Project Office: Kay Lewandowski, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, Baltimore, Maryland 21207.
Demonstration Title/State: Project Demonstrating and Evaluating
Alternative Methods to Assure and Enhance the Quality of Long Term Care
Services for Persons with Developmental Disabilities through
Performance-Based Contracts with Service Providers--Minnesota
[[Page 16483]]
Description: The purpose of this project is to determine whether
and how well the implementation of new approaches to quality assurance,
with outcome-based definitions and measures of quality, will replace
the input and process measures of quality, and in the process
contribute to improving quality of life for persons with developmental
disabilities. The Minnesota Department of Human Services will seek
Federal authority to waive necessary provisions of intermediate care
facilities for the mentally retarded (ICFs/MR) regulations to permit
alternative quality assurance mechanisms in selected demonstration,
residential, and support service programs. The Department will enter
into performance-based contracts with counties, and participating ICF/
MR providers. Desirable outcomes include, among others, the enhancement
of consumer choice and autonomy, employment, and integration into the
community. This project is in the developmental stage.
Date Received: March 25, 1994.
State Contact: Helen M. Yates, Minnesota Department of Human
Services, Health Care Administration, 44 Lafayette Road, St. Paul,
Minnesota 55155-3853.
Federal Project Officer: Samuel M. Brown, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
5. Approved Proposals
Demonstration Title/State: OhioCare--Ohio.
Description: Ohio will expand Medicaid eligibility to include
uninsured persons with incomes up to 100 percent of the Federal poverty
level. New and current eligibles in this statewide program will receive
services through managed care. Certain special health related services,
such as mental health and drug and alcohol addiction services, will
also be provided through managed care.
Date Received: March 2, 1994.
Date Awarded: January 17, 1995.
Implementation Date: (Proposed) January 1, 1996.
State Contact: Kathi Glynn, Director, Ohio Medicaid, 30 East Broad
Street, Columbus, Ohio 43266, (614) 644-0140.
Federal Project Officer: David Walsh, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
6. Disapproved Proposals
No comprehensive health reform proposals have been disapproved
since January 1, 1993.
B. Other Section 1115 Demonstration Proposals
1. New Proposals
No new proposals were received during the month of January.
2. Pending Proposals
Demonstration Title/State: Georgia's Children's Benefit Plan.
Description: The State of Georgia submitted a Section 1115 proposal
entitled ``Georgia Children's Benefit Plan'' that provides preventive
and primary care services for children 1 through 5 years of age who are
between 133 and 185 percent of the Federal poverty level. The duration
of the waiver is 5 years with proposed project dates of July 1, 1995 to
June 30, 2000.
Date Received: December 12, 1994.
State Contact: Jacquelyn Foster-Rice, Georgia Department of Medical
Assistance, 2 Peachtree Street NW, 201 South Grand Avenue East,
Atlanta, Georgia 30303-3159, (404) 651-5785.
Federal Project Officer: Maria Boulmetis, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: High Cost User Initiative--Maryland.
Description: Maryland proposes to implement an integrated case
management system for high-cost, high-risk Medicaid recipients.
Date Received: July 8, 1994.
State Contact: John Folkemer, Maryland Department of Health and
Mental Hygiene, Office of Medical Assistance Policy, 201 West Preston
Street, Baltimore, Maryland 21201, (410) 225-5206.
Federal Project Officer: Rosana Hernandez, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Minnesota Long-Term Care Options
Project--Minnesota.
Description: The State proposes to integrate long-term care and
acute care services under combined Medicare and Medicaid capitation
payments for elderly dual eligibles.
Date Received: April 18, 1994.
State Contact: Pamela Parker, Minnesota Department of Human
Services, Human Services Building, 444 Lafayette Road North, St. Paul,
Minnesota 55155, (612) 296-2140.
Federal Project Officer: Melissa McNiff, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Family Planning Proposal--New Mexico.
Description: New Mexico proposes to extend Medicaid eligibility for
family planning services to all women of childbearing age with incomes
at or below 185 percent of the Federal poverty level.
Date Received: November 1, 1994.
State Contact: Bruce Weydemeyer, Director, Division of Medical
Assistance, P.O. Box 2348, Santa Fe, New Mexico 87504-2348, (505) 827-
3106.
Federal Project Officer: Alisa Adamo, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Pay-in Spenddown Pilot--Ohio.
Description: Ohio proposes to implement a one-county pilot program
to simplify Medicaid eligibility administration. It would allow the
medically needy to pay in spenddown amounts in order to qualify for
Medicaid.
Date Received: April 28, 1994.
State Contact: Jeanne Carroll, Ohio Department of Human Services,
30 East Broad Street, Columbus, Ohio 43266, (614) 466-6024.
Federal Project Officer: David Walsh, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: CHOICES--Citizenship, Health,
Opportunities, Interdependence, Choices and Supports--Rhode Island.
Description: Rhode Island proposes to consolidate all current State
and Federal funding streams for adults with developmental disabilities
under one program using managed care/managed competition.
Date Received: April 5, 1994.
State Contact: Susan Babin, Department of Mental Health,
Retardation, and Hospitals, Division of Developmental Disabilities, 600
New London Avenue, Cranston, Rhode Island 02920, (401) 464-3234.
Federal Project Officer: Melissa McNiff, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
[[Page 16484]] Demonstration Title/State: Virginia.
Description: Virginia proposes to expand Medicaid eligibility to
children in the State-funded KIDS CARE program, and provide them with a
limited Medicaid benefit restricted to ambulatory services.
Date Received: May 18, 1994.
State Contact: Janet Kennedy, Suite 1300, 600 East Broad Street,
Richmond, Virginia 23219, (804) 371-8855.
Federal Project Officer: Maria Boulmetis, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Family Planning Demonstration--
Washington.
Description: The State proposes to provide family planning services
to low-income women for an additional 10 months postpartum, which will
extend total coverage for such services to one year.
Date Received: April 21, 1994.
State Contact: Claudia Lewis, Medical Assistance Administration,
Division of Client Services, P.O. Box 45530, Olympia, Washington 98504-
5530, (206) 586-2751.
Federal Project Officer: Maria Boulmetis, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Wisconsin.
Description: The State proposes to limit the amount of exempt funds
that may be set aside as burial and related expenses for SSI-related
Medicaid recipients.
Date Received: March 9, 1994.
State Contact: Jean Sheil, Division of Economic Support, Wisconsin
Department of Health and Social Services, 1 West Wilson Street, Room
650, P.O. Box 7850, Madison, Wisconsin 53707, (608) 266-0613.
Federal Project Officer: J. Donald Sherwood, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
3. Approved Conceptual Proposals (Award of Waivers Pending)
No conceptual proposals were approved during the month of January.
4. Approved Proposals
The following projects were inadvertently omitted from the list of
pending proposals published in the Federal Register on January 23, 1995
(60 FR 4418).
Demonstration Title/State: The Multistate Nursing Home Case-Mix and
Quality Demonstration--Kansas.
Description: This demonstration tests a combined Medicare and
Medicaid nursing home payment and quality monitoring system. The system
significantly enhances the quality assurance process in SNFs. Data for
measuring quality of care will come from an expanded version of the
standardized resident assessment instrument currently used by States
for all nursing home residents. The same tool that is used in care
planning, which measures residents' needs, strengths, and preferences,
will be used to determine Medicare and Medicaid payment. In the
developmental phase of the demonstration, data from the assessment
instruments were used to create 30 facility-level quality indicators.
Under the demonstration, these indicators will help facilities
benchmark their own performance and help Medicare and Medicaid target
nursing home surveys.
Date Received: Winter 1989.
Date Awarded: January 1995.
Implementation Date: (Proposed) Summer 1995.
State Contact: Evelyn McCormick, R.N., Case Mix Demonstration
Project Director, Department of Social And Rehabilitation Services
Docking State Office Building, Room 628 South, 915 Southwest Harrison,
Topeka, Kansas 66612-1570, (913) 296-4752.
Federal Project Officer: Elizabeth Cornelius, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: The Multistate Nursing Home Case-Mix and
Quality Demonstration--Maine.
Description: This demonstration tests a combined Medicare and
Medicaid nursing home payment and quality monitoring system. The system
significantly enhances the quality assurance process in SNFs. Data for
measuring quality of care will come from an expanded version of the
standardized resident assessment instrument currently used by States
for all nursing home residents. The same tool that is used in care
planning, which measures residents' needs, strengths, and preferences,
will be used to determine Medicare and Medicaid payment. In the
developmental phase of the demonstration, data from the assessment
instruments were used to create 30 facility-level quality indicators.
Under the demonstration, these indicators will help facilities
benchmark their own performance and help Medicare and Medicaid target
nursing home surveys.
Date Received: Winter 1989.
Date Awarded: January 1995.
Implementation Date: (Proposed) Summer 1995.
State Contact: Alison Moore, R.N., M.B.A., Case Mix Demonstration
Project Director, Bureau of Medical Services, Maine Department of Human
Services, State House Station 11, Augusta, Maine 04333, (207) 287-3838.
Federal Project Officer: Elizabeth Cornelius, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: The Multistate Nursing Home Case-Mix and
Quality Demonstration--Mississippi.
Description: This demonstration tests a combined Medicare and
Medicaid nursing home payment and quality monitoring system. The system
significantly enhances the quality assurance process in SNFs. Data for
measuring quality of care will come from an expanded version of the
standardized resident assessment instrument currently used by States
for all nursing home residents. The same tool that is used in care
planning, which measures residents' needs, strengths, and preferences,
will be used to determine Medicare and Medicaid payment. In the
developmental phase of the demonstration, data from the assessment
instruments were used to create 30 facility-level quality indicators.
Under the demonstration, these indicators will help facilities
benchmark their own performance and help Medicare and Medicaid target
nursing home surveys.
Date Received: Winter 1989.
Date Awarded: January 1995.
Implementation Date: (Proposed) Summer 1995.
State Contact: Jamie Collier, Case Mix Demonstration Project
Director Division of Medicaid, Robert E. Lee Building, Suite 801, 239
North Lamar Street, Jackson, Mississippi, (601) 359-6081.
Federal Project Officer: Elizabeth Cornelius, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: The Multistate Nursing Home Case-Mix and
Quality Demonstration--New York.
Description: This demonstration tests a combined Medicare and
Medicaid nursing home payment and quality monitoring system. The system
[[Page 16485]] significantly enhances the quality assurance process in
SNFs. Data for measuring quality of care will come from an expanded
version of the standardized resident assessment instrument currently
used by States for all nursing home residents. The same tool that is
used in care planning, which measures residents' needs, strengths, and
preferences, will be used to determine Medicare and Medicaid payment.
In the developmental phase of the demonstration, data from the
assessment instruments were used to create 30 facility-level quality
indicators. Under the demonstration, these indicators will help
facilities benchmark their own performance and help Medicare and
Medicaid target nursing home surveys.
Date Received: Winter 1989.
Date Awarded: January 1995.
Implementation Date: (Proposed) Summer 1995.
State Contact: David H. Wilcox, CPA, Case Mix Demonstration Project
Director, Bureau of Health Economics, 1143 Corning Tower, Empire State
Plaza, Albany, New York 12237-0722, (518) 474-2881.
Federal Project Officer: Elizabeth Cornelius, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: The Multistate Nursing Home Case-Mix and
Quality Demonstration--South Dakota.
Description: This demonstration tests a combined Medicare and
Medicaid nursing home payment and quality monitoring system. The system
significantly enhances the quality assurance process in SNFs. Data for
measuring quality of care will come from an expanded version of the
standardized resident assessment instrument currently used by States
for all nursing home residents. The same tool that is used in care
planning, which measures residents' needs, strengths, and preferences,
will be used to determine Medicare and Medicaid payment. In the
developmental phase of the demonstration, data from the assessment
instruments were used to create 30 facility-level quality indicators.
Under the demonstration, these indicators will help facilities
benchmark their own performance and help Medicare and Medicaid target
nursing home surveys.
Date Received: Winter 1989.
Date Awarded: January 1995.
Implementation Date: (Proposed) Summer 1995.
State Contact: Carol Job, R.N., Case Mix Demonstration Project
Director, Department of Social Services and Aging, 700 Governors Drive,
Pierre, South Dakota 57501-2291, (605) 773-3656.
Federal Project Officer: Elizabeth Cornelius, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: The Multistate Nursing Home Case-Mix and
Quality Demonstration--Texas.
Description: This demonstration tests a combined Medicare and
Medicaid nursing home payment and quality monitoring system. The system
significantly enhances the quality assurance process in SNFs. Data for
measuring quality of care will come from an expanded version of the
standardized resident assessment instrument currently used by States
for all nursing home residents. The same tool that is used in care
planning, which measures residents' needs, strengths, and preferences,
will be used to determine Medicare and Medicaid payment. In the
developmental phase of the demonstration, data from the assessment
instruments were used to create 30 facility-level quality indicators.
Under the demonstration, these indicators will help facilities
benchmark their own performance and help Medicare and Medicaid target
nursing home surveys.
Date Received: Winter 1989.
Date Awarded: January 1995.
Implementation Date: (Proposed) Summer 1995.
State Contact: Sue Wilson, Case Mix Demonstration Project Director
Rate Analysis Department, Texas Department of Human Services P.O. Box
149030, Mailcode W-425, Austin, Texas 78714-9030 (512) 450-3744
Federal Project Officer: Elizabeth Cornelius, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
The following proposal was approved in January 1995.
Demonstration Title/State: Demonstration Project for Family
Planning and Reproductive Services--Maryland.
Description: Maryland will extend Medicaid eligibility for family
planning and preventive reproductive services for a 5-year period to
women who are Medicaid eligible due to their pregnancy and remain
Medicaid eligible 60-days post-partum.
Date Received: June 11, 1994.
Date Awarded: January 18, 1995.
Implementation Date: Not yet determined
State Contact: Jane Forman, Department of Health and Mental Hygiene
Room 137, 201 West Preston Street, Baltimore, Maryland 21201, (410)
225-6538
Federal Project Officer: Alisa Adamo, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
The following are projects approved since January 1, 1993, in
addition to those published in the Federal Register on January 23, 1995
(60 FR 4418).
Demonstration Title/State: Medicaid Direct Purchase Vaccine Program
(MDPVP)--Arkansas.
Description: The MDPVP streamlines the reimbursement process for
vaccines, by allowing States to directly reimburse manufacturers for
vaccines. Vaccine manufacturers send a shipment of vaccines on
consignment at no cost to each private physician who treats children on
Medicaid. Physicians then bill Medicaid for the office visit when they
inoculate children, but not for the cost of the vaccine. The Medicaid
program will reimburse the manufacturer directly at a discounted rate,
according to the number of vaccines administered. The manufacturer will
then send replacement quantities of the vaccines to the private
physicians.
Date Received: March 1993.
Date Awarded: June 1993.
Implementation Date: Not Yet Determined.
State Contact: Judy Kerr, Arkansas Department of Human Services,
Division of Economic and Medical Services, Donaghey Plaza South, P.O.
Box 1437 Little Rock, Arkansas 72203-1437, (501) 682-8360.
Federal Project Officer: Alisa Adamo, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Improving Access to Care for Pregnant
Substance Abusers--Massachusetts.
Description: This demonstration seeks to increase the number of
Medicaid-eligible pregnant substance abusers who receive coordinated
perinatal care services, substance abuse treatment, and other relevant
services to promote better health outcomes for themselves and their
offspring.
Date Received: 1991.
Date Awarded: July 1, 1993.
Implementation Date: July 1993.
State Contact: Milton Argeriou, Ph.D. Project Director, MOTHERS
Project, 200 [[Page 16486]] Lincoln Street, Suite 303, Boston,
Massachusetts 02111, (617) 426-5997.
Federal Project Officer: Debbie Van Hoven, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Improving Access to Care for Pregnant
Substance Abusers--New York.
Description: This demonstration seeks to increase the number of
Medicaid-eligible pregnant substance abusers who receive coordinated
perinatal care services, substance abuse treatment, and other relevant
services to promote better health outcomes for themselves and their
offspring.
Date Received: 1991.
Date Awarded: July 1, 1993.
Implementation Date: July 1993.
State Contact: Mr. Stuart Lefkowich, Assistant Commissioner, Bureau
of Primary Care, Division of Health and Long Term Care, New York State
Department of Social Services, 40 North Pearl Street, Albany, New York
12243-0001, (518) 473-5875
Federal Project Officer: Sherrie Fried, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Health Access Plan--South Carolina.
Description: This project tests the effects on individuals' access
to and cost of health care of eliminating categorical eligibility
requirements and of raising the financial eligibility limits to 150
percent of the Federal poverty level.
Date Received: Spring 1991.
Date Awarded: February 1993.
Implementation Date: March 1993.
State Contact: Bruce Bondo, Health and Human Services Finance
Commission, 1801 Main Street, Columbia, South Carolina 29201, (803)
253-6177.
Federal Project Officer: Jamie Hadley, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Improving Access to Care for Pregnant
Substance Abusers--South Carolina.
Description: This demonstration seeks to increase the number of
Medicaid-eligible pregnant substance abusers who receive coordinated
perinatal care services, substance abuse treatment, and other relevant
services to promote better health outcomes for themselves and their
offspring.
Date Received: 1991.
Date Awarded: July 1, 1993.
Implementation Date: July 1993.
State Contact: Bunny W. Jones, State Health and Human Services
Finance Commission, Department of High Risk and Maternal Care, P.O. Box
8206, Columbia, South Carolina 29202-8206, (803) 253-6374.
Federal Project Officer: Debbie Van Hoven, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Health Access Plan--Washington.
Description: This project tests the effects of eliminating
categorical eligibility requirements and raising the financial
eligibility limits to 200 percent of the Federal poverty level on
individuals' access to and cost of health care.
Date Received: Spring 1991.
Date Awarded: February 1993.
Implementation Date: March 1993.
State Contact: Rochelle Salsman, Department of Health and Social
Services, Medical Assistance Administration, Office of Recipient
Services, 617 8th Avenue, SE., 4th Floor, P.O. Box 45530, Olympia,
Washington 98504, (206) 753-7463.
Federal Project Officer: Jamie Hadley, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
Demonstration Title/State: Improving Access to Care for Pregnant
Substance Abusers--Washington.
Description: This demonstration seeks to increase the number of
Medicaid-eligible pregnant substance abusers who receive coordinated
perinatal care services, substance abuse treatment, and other relevant
services to promote better health outcomes for themselves and their
offspring.
Date Received: 1991.
Date Awarded: July 1, 1993.
Implementation Date: July 1993.
State Contact: Kathy L. Apodaca, First Steps Plus Project, Medical
Assistance Administration, Washington State Department of Health, P.O.
Box 45730, Olympia, Washington 98504, (509) 575-2227.
Federal Project Officer: Alisa Adamo, Health Care Financing
Administration, Office of Research and Demonstrations, 2302 Oak
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
5. Disapproved Proposals
No proposals were disapproved during the month of January.
III. Requests for Copies of a Proposal
Requests for copies of a specific Medicaid proposal should be made
to the State contact listed for the specific proposal. If further help
or information is needed, inquiries should be directed to HCFA at the
address above.
(Catalog of Federal Domestic Assistance Program, No. 93.779; Health
Financing Research, Demonstrations, and Experiments.)
Dated: March 21, 1995.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 95-7848 Filed 3-29-95; 8:45 am]
BILLING CODE 4120-01-P
This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.