Rep. Reginald Murdock, the Democratic vice-chair of the House Public Health committee, got in touch regarding my post yesterday about the amendment to the private option which would limit non-emergency medical transportation (NEMT) for beneficiaries. A new study found that eliminating the guaranteed NEMT benefit could harm the most vulnerable patients.
Murdock e-mailed to say that Arkansas will design its own NEMT waiver** to protect the state’s neediest citizens:
Please note that in negotiations concerning the asking for a waiver from HHS, I was in the room and was guaranteed that the most needy citizens will not be negatively affected. Conversely, i was given the assurance in a conversation with Gov. Beebe and Director Selig, that we will only be seeking a waiver to allow us to structure our own plan. That plan would be carefully scrutinized so that the very issue you raise will NOT happen to our citizens here in Arkansas. I, as will others, will be carefully watching the roll out of this plan and feel very confident that the Governor and Director Selig will not allow for such an occurrence as well.
As I noted in yesterday’s post, Murdock’s point is a key caveat: rather than just completely eliminating NEMT, as Iowa got permission to do over a one-year demonstration, Arkansas will be tailoring a state-specific plan that hopefully will be designed to protect those most in need — the state will still be required to provide transportation to private option beneficiaries in certain cases. It’s encouraging that Gov. Mike Beebe and DHS Director John Selig are sensitive to the stakes here, and Republicans Sen. David Sanders and Rep. John Burris, who pushed for the NEMT waiver, have also publicly said that the Arkansas waiver will ensure that those truly dependent on NEMT will have access to it.
It’s again worth noting that Arkansas is pursuing the private option via an 1115 “demonstration waiver,” which is explicitly designed as an experiment. Perhaps Arkansas will be able to develop an approach to NEMT that both encourages more efficient utilization of transportation services and ensures that the state’s neediest citizens have access to care. It’s hard to speculate at this point since the waiver request from the Arkansas Department of Human Services is still in development and no specific details have been released. We’ll be watching closely. Sounds like Murdock will be too.
**Federal rules mandate that all Medicaid beneficiaries are guaranteed the NEMT benefit. Arkansas is seeking a waiver of those rules that would allow the state to limit this benefit for private option beneficiaries. See our report from last month for more on NEMT and the private option.