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Formerly lost Medicaid benefits now restored by state:More than 2,800 in Boyle get dental, vision, non-emergency transportation benefits reinstated

The Kentucky Cabinet for Health and Family Services has issued a press release saying it will be reinstating the payment of dental, vision and non-emergency transportation costs for thousands of Kentuckians covered under expanded Medicaid.

“Hopefully, this helps people maintain coverage while the Bevin administration develops future plans to revamp the system,” said Brent Blevins, director of the Boyle County Health Department.

Blevins, like many others in the state, had previously voiced concern when those benefits were canceled for almost half a million Kentuckians on expanded Medicaid.

Gov. Bevin’s plan, called Kentucky HEALTH (or the 1115 waiver), which stands for “Helping Engage and Achieve Long-Term Health,” was blocked June 29, two days before it was due to go into effect, by a federal judge. State officials said the judge’s decision left no way for people to earn the benefits, nor a way for the state to pay for them.

Many called “foul” on that claim, since Gov. Bevin had already filed an executive order for his administration to end Medicaid expansion if any part of the 1115 Medicaid waiver his and the Trump administrations were pushing was halted due to a legal challenge. A lawsuit filed by Medicaid recipients asserted the waiver was illegal and would result in many losing benefits.

U.S. District Court Judge James Boasberg ruled the Trump administration didn’t consider coverage losses that would result in the work requirements, saying it goes against the Medicaid program’s aim of providing health insurance. The judge’s concerns were that they had not addressed the state’s forecast that the plan would cause tens of thousands of people to lose medical coverage.

It wasn’t long after that ruling the state Cabinet for Health and Family Services posted a public notice on its website that vision and dental services would be no longer be covered by members’ My Rewards accounts.

Under the new plan, which was supposed to go into effect July 1, members could regain the benefits by participating in multiple different “self-improvement” activities, such as job training, wellness activities, weight-loss programs or passing the GED, for example. They could also gain credits by working.

There are 460,000 Kentuckians receiving benefits under expanded Medicaid; locally, in Boyle County, there are 2,831 covered by it. When it was abruptly announced reimbursements would not be made for those services, some offices were flooded with calls, either from those who were losing the benefits or from providers.

Emily Beauregard, executive director for Kentucky Voices for Health (KVH), an advocacy group with offices in Frankfort and Louisville, previously said they had received calls from providers because they didn’t know who was covered, and were canceling services for members.

As of now, with the newest release from the cabinet out there, some of those phone calls have quelled, says Angela Koch, state outreach and education director with KVH.

“Since the state was relatively explicit that it will be retroactive to July 1, that signals to providers that they will be reimbursed for those services,” Koch said. “There’s still a bit of a scramble, though, with appointments that had been canceled, fitting those people back in to get their services.”

The press release by the cabinet said, “We had hoped for a quick federal re-approval that would allow the transformative Kentucky HEALTH program to start August 1, avoiding delayed access to services.”

The Centers for Medicare and Medicaid Services (CMS) will hold a 30-day federal comment and evaluation period “making it clear that the program will not begin as soon as we hoped,” the release stated.

It said “system changes are risky and cannot be made overnight,” and the cabinet will temporarily restore benefits by Aug. 1. It has also created a “manual system work-around” that will allow payments of claims during the month of July.

The expanded program began in 2014, under the Patient Protection and Affordable Care Act, by then-Gov. Steve Beshear.

Al Cross with Kentucky Health News said Bevin doubled a $500,000 contract with a Cincinnati law firm to investigate Beshear’s administration, and called this the “latest skirmish” between Bevin and Democratic Attorney General Andy Beshear. Andy Beshear has announced he will run for governor, while Bevin has not said if he will seek another term or not. 

“The message we want the general population to get is: Go get care. You can see your dentist — today — and there’s a new federal comment period open,” Koch said. The comment period is open so people can comment on the 1115 waiver as a whole, she said.

“It’s on the comments by Kentuckians that the judge knocked down the waiver, so we’re now back to square one. There were 3,000 comments from Kentuckians, more comments than ever collected about a waiver like this before,” Koch said.

“The waivers — what they are supposed to be for is to implement innovative programs that change Medicaid for the better. As health care advocates, we don’t think that’s what this waiver does, even though they’ve called it Kentucky ‘HEALTH,’” Koch said. “Instead, it creates barriers and red tape instead of eliminating them. So Kentuckians should go online and submit comments about the waiver while the 30-day period is still going on. It’s very important.”

SO YOU KNOW

To comment during the federal evaluation period on Kentucky HEALTH, also called the 1115 waiver, which makes a number of changes to how Medicaid benefits are administered, go to http://bit.ly/2JNLCGa. Comments will be accepted through Aug. 18.