Presentation for SCI Nashville, Tennessee February 7, 2008 .


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Wisconsin’s. Presentation for SCI Nashville, Tennessee February 7, 2008. Overview of BadgerCare Plus The Federal Approval Process State Budget Approval BadgerCare Plus Deployment BadgerCare Plus for Childless Adults and BadgerConnect. Affordable, comprehensive health care coverage
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Slide 1

Wisconsin\'s Presentation for SCI Nashville, Tennessee February 7, 2008

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Overview of BadgerCare Plus The Federal Approval Process State Budget Approval BadgerCare Plus Deployment BadgerCare Plus for Childless Adults and BadgerConnect

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Affordable, exhaustive medicinal services scope for all youngsters in Wisconsin

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Program Design Create one far reaching program by solidifying Family Medicaid, BadgerCare (SCHIP), and Healthy Start Simplify enlistment and organization

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Program Design Four vital objectives: Cover all children Provide scope and improved advantages for pregnant ladies Make the program basic Promote aversion and sound practices

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BadgerCare Plus – Expansion populaces: All kids without access to moderate medical coverage Pregnant ladies with salaries no more prominent than 300% of FPL Parents and overseer relatives with livelihoods underneath 200% of FPL

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BadgerCare Plus – Expansion Populations (proceeded with): Youth (ages 18 through 20) maturing out of child care paying little respect to salary Parents with kids in child care with earnings up to 200% of FPL Certain independently employed guardians & agriculturists with wages up to 200% of FPL (contingent upon deterioration)

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BadgerCare Plus Population Covered Populations FPL 300% No Income Limit BadgerCare Plus Expansion Current BadgerCare Current Medicaid & Healthy Start Self-Employed/Farmers 200% No Income Limit 185% 150% 100% 44% Pregnant Women Children 0-18 Parents Caretaker Relatives Youth Exiting Out-of-home Care

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BadgerCare Plus – Streamlining Eligibility Simplified gross pay test Only two conclusions - Student earned wage slight - Child bolster commitment neglect

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BadgerCare Plus – Streamlining Eligibility Express Enrollment -kids beneath 150% of FPL - pregnant ladies Spenddown for pregnant ladies to 300% of FPL Spenddown for kids with calamitous human services episodes to 150% of FPL

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BadgerCare Plus – Streamlining Eligibility Increase utilization of electronic applications utilizing ACCESS Health chance evaluation device Crowd out arrangements Direct strategies Indirect approaches

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BadgerCare Plus – Streamlining Eligibility No Employer Verification Form Automated confirmation of protection scope and get to by means of bosses Annual restoration Backdating for guardians & kids under 150% of FPL and all pregnant ladies

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BadgerCare Plus – Streamlining Eligibility Reduced Reporting Alignment with FoodShare arrangements (unmerited wage, independent work pay, and so forth.) Simpler gathering piece leads (no Family Fiscal Unit)

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BadgerCare Plus – Benefit Plans Two unmistakable arrangements Standard Plan = current Medicaid advantage bundle for those with wages under 200% of FPL New Benchmark Plan for those with wages above 200% of FPL and certain independently employed families

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BadgerCare Plus – Benefit Plans Benchmark plan depends on biggest, minimal effort, business arrange Four advantages added to essential arrangement Prescription Drugs Early Childhood Development Services Dental Services Mental Health/AODA

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BadgerCare Plus Benefits Benefit Package 300% No Income Limit Benchmark Plan Medicaid advantage bundle Self-Employed/Farmers 200% No Income Limit Pregnant Women Children 0-18 Parents Caretaker Relatives Youth Exiting Out-of-home Care

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BadgerCare Plus – Cost Sharing Premium gatherings: Children with wages > 200% FPL Parents and guardians with wages between 150 & 200% of FPL Certain independently employed guardians with wages < 200% of FPL

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BadgerCare Plus – Cost Sharing 5% wage top connected in total, crosswise over grown-ups with wages < 200 % of FPL Certain ranch families—5% of gross pay with devaluation included Enrollees with wages > 200% of FPL will have co-pays Restrictive enlistment for inability to pay premiums

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BadgerCare Plus – Federal Approval On 6/30/07, CMS broadened the BadgerCare s. 1115(a) Waiver to 3/31/10. On 11/27/07, CMS endorsed the SCHIP and Medicaid state arrange changes presented that give us with endorsement to BadgerCare Plus. CMS has not corrected the BadgerCare s. 1115(a) waiver, which would\'ve permitted us to assert SCHIP financing for overseer relatives in similar way that we accomplish for grown-ups.

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BadgerCare Plus for Childless Adults Implementation: January 1, 2009

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BadgerCare Plus for Childless Adults A "childless grown-up" is any individual who is not: A kid under 19 years old; Pregnant; A parent dwelling with a child/little girl under age 19; An overseer relative who lives with and deals with youngsters under age 19, where the parent is missing; A man with handicaps; A man 65 years old or more seasoned; and, Anyone else who meets all requirements for full-advantage Medicaid or BadgerCare Plus.

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BadgerCare Plus for Childless Adults The 07-09 Biennial Budget incorporates approval to grow BadgerCare Plus to cover childless grown-ups who are uninsured and have salary not surpassing 200%. Their human services arrange (BadgerCare Plus Core Plan) will be less liberal than the BadgerCare Plus Benchmark Plan and will be conveyed through an oversaw mind demonstrate, aside from that psychological wellness administrations would be given by the areas. We expect that 71,000 childless grown-ups will be qualified to select in the program. The program needs to facilitate with the General Assistance Medical Program (GAMP) in Milwaukee, the Family Planning Waiver, the AIDS/HIV program, the Wisconsin Chronic Disease program and the Health Insurance Risk Sharing Plan (HIRSP).

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BadgerCare Plus for Childless Adults Federal endorsement for this arrangement is required. No subsidizing for advantages or organization was incorporated into the financial plan, yet the power to execute is currently in state law. BadgerCare Plus for Childless Adults will utilize similar qualification improvements that we set up with BadgerCare Plus. BadgerChoice Proactive Identification and Enrollment Member Services Centralized Enrollment Health Needs Assessment HMO Choice and Automatic Assignment Employer \'Purchase Up\' to BC+ Core Plus Benefits

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Questions? Contact Information Jim Jones, Deputy Administrator Division of Health Care Access & Accountability Wisconsin Department of Health and Family Services jonesjd@dhfs.state.wi.us (608) 266-5312 Fax: (608) 266-6786

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