Changes in Medicaid Rules Sought

NASW Executive Director Elizabeth J. Clark submitted comments on behalf of NASW to the Center for Medicaid and Medicare Services (CMS) addressing proposed changes in state flexibility for Medicaid benefit packages.

"NASW is concerned that the reliance on commercial benefit plans is inappropriate for Medicaid recipients," Clark said in her message. "We are especially concerned that many private insurance plans do not provide adequate mental health services; therefore, providing significant challenges to people with serious and persistent mental illness."

The executive director explained that in the proposed rule, some people with mental illness will not be included in an exempt group. "NASW strongly supports their inclusion, because we know that ensuring people with mental illness receive the services they need allows them an important quality of life. We are concerned that benchmark plans, especially those tied to commercial benefits plans, will not be able to meet those needs."

NASW is also urging CMS to require states to provide more information and assistance to exempt individuals who are given the option to enroll in alternative coverage.

Individuals often have specific health needs, and in addition to written information, benefits counselors may be needed to adequately assess the options and provide the best coverage for the enrollee, the letter stated.

"We know that when people are able to access health care earlier in any disease process, outcomes for restoring health are greater," Clark said. "When people cannot get the services they need, the likelihood of more complex and more expensive remedies increases. Efforts to match people with the plan that is best for them are crucial."

NASW also urged CMS to reconsider its decision allowing benchmark plans to not provide transportation to medical services. "If this proposal becomes effective, it would limit access to critically important treatment, and it particularly affects our members' ability to manage chronic illness and disease for the most vulnerable and underserved populations of our society," the letter stated. "Having benefits, but not being able to access them due to lack of funds for transportation does not allow for the most cost-effective use of Medicaid dollars."