Monday, April 5, 2010

Improvements to BadgerCare Plus May Yield Federal Bonus Funding

The Department of Health Services (DHS) continues to make improvements in the BadgerCare Plus program, taking advantage of opportunities provided by the Children’s Health Insurance Program Reauthorization Act (CHIPRA). The latest change, which was announced by DHS last week, will help expedite the annual renewal process for BadgerCare Plus. It may also enable WI to qualify for extra financial assistance.

States are eligible for CHIPRA bonus funding if they exceed certain targets for increasing Medicaid enrollment of children, and if they meet 5 of 8 CHIPRA standards for improving policies relating enrollment and retention. The bonus is a significant increase in the federal match rate for each Medicaid child above the growth target.

One of the 8 standards is expediting the renewal process by automatically using recent income figures or other relevant information from other state databases. This administrative or “ex parte” renewal approach allows a state to keep eligible kids covered with negligible paperwork.

DHS took initial steps toward meeting that standard in January 2010, when it began allowing online renewal, including use of “pre-populated" forms for people coming up for their annual review. Those forms automatically fill in information needed for renewal if it is accessible in the state’s computer databases. However, federal officials told DHS that making this option available only to people who apply online would not be sufficient to meet this particular standard for bonus funding.

On March 29, DHS issued an Operations Memo (#10-25) that initiates the use of prepopulated forms for people who request mail-in renewal applications. This change appears to be sufficient for WI to meet the administrative renewal standard. If so, it would be the 5th standard WI meets and should make our state eligible for CHIPRA bonus funding in the current federal fiscal year.

We don’t know exactly how much bonus funding WI could potentially receive, and the exact amount will be affected by enrollment changes over the course of the current federal fiscal year (through Sept.); however, the amount is probably on the order of a few million dollars per year. That funding will help the state maintain and continue to strengthen BadgerCare Plus coverage for Wisconsin children.

The administrative reforms are also valuable in themselves, because they make it easier for eligible children to keep the BadgerCare Plus coverage that helps them grow and thrive. And that means parents struggling through the recession get some badly-needed peace of mind and our state spends health dollars more wisely, on prevention instead of expensive ER care for problems that didn’t have to become emergencies.

I have been regularly updating a checklist of options created by CHIPRA to improve access to health care for children. The latest version, updated late last week, describes the standards states can meet to qualify for bonus funding and the status of Wisconsin’s efforts to meet 5 of those standards.

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