Section 1115 Demonstrations: MO Gateway to Better Health
The CMS Idea Factory is the tool by which CMS is gathering public comments on pending Section 1115 demonstrations. Please see the instructions below regarding how you can post a comment regarding a pending Section 1115 demonstration.
Section 1115 demonstrations, which enable states to test coverage and delivery system approaches in Medicaid and CHIP, have a significant and varied impact on Medicaid and CHIP beneficiaries, providers, States, Tribes, and local governments. The Centers for Medicare & Medicaid Services (CMS) values public input during the demonstration application Federal review process and has provided a platform for public submission of comments. Listed below is a description of the process and timelines for the Federal public comment process. For more specifics, please see the State Health Official (SHO) letter or regulation.
Once a State’s 30-day public comment period has ended, the State will submit an application to CMS. Within 15 days of receipt of the application, CMS determines whether the application is complete and will notify the State. If CMS determines that the application is complete, CMS will send the State written notice informing the State of receipt of the complete application, the date on which the Secretary received the application, and the start date of the 30-day Federal public notice period. If CMS determines that the application is not complete, CMS will notify the State of any missing elements in the application.
Each pending demonstration has a 30-day Federal open public comment period for the general public and stakeholders to submit comments. CMS will not act on the demonstration request until 15 days, at a minimum, after the conclusion of the public comment period. CMS will continue to accept comments beyond the 30-day period; however, CMS cannot guarantee that comments received after the 30-day comment period will be considered due to the need for a timely Federal response. Therefore, CMS strongly encourages comments to be submitted within the 30-day Federal comment period.
To use this forum
- Review comments that have already been posted by searching or browsing.
- Concur with an existing comment by using the “Voting Function” to indicate your agreement with it. Alternatively, type a new comment and select a category for your comments. You have up to 10 concurrences (votes) that you can use to show that you concur with specific comments. You can use one concurrence at a time or you can use multiple concurrences for one comment. CMS does not measure public input or make decisions based on the number of comments or concurrences made, but your concurrence through voting helps inform our review of demonstration applications.You can use the additional space provided to describe your comments in more detail. There is a 5,000 character limit.
- Enter your email address to sign in or sign up for an account.
Please note that CMS will review all comments, but the number of concurrences will not determine CMS’s policy. This is a moderated forum, and comments will not be posted immediately.
About the Missouri Gateway to Better Health
According to information provided by the State, under this demonstration, Missouri expects to promote the objectives of title XIX by 1) preserving the St. Louis City and St. Louis County safety net of health care services available to the uninsured until a transition to health care coverage is available under the Affordable Care Act (ACA); 2) connecting the uninsured to a primary care home which will enhance coordination, quality, and efficiency of health care through patient and provider involvement; 3) maintaining and enhancing quality service delivery strategies to reduce health disparities; 4) have the affiliated safety net providers provide health care services to an additional 2 percent of uninsured individuals over the current services levels by July 1, 2012 and 5) transition the affiliation partner community to a coverage model, as opposed to a direct payment model, by July 1, 2012.
Status: Pending Request for Amending of Demonstration, Closed
Public Comment Period: Closed
Pending Documents
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Why doesn't this plan cover behavioral, mental health, and substance abuse services?
A health insurance plan may need to cover beharvioral, mental health, and substance abuse services in order to adequately address these and other socioeconomic barriers to care. It is forseeable that there will continue to be a rise in patients using the emergency department with mental health and substance abuse challenges, and this impacts morbidity and mortality. The decision of whether to include mental health and substance abuse services in a government health insurance plan may impact whether frequent users of the emergency department can have access to these services at all, and also whether patients with these needs choose…
1 vote -
Why two tiers? Why do some patients have coverage for both primary and specialty services while others only for specialty services?
How would this compare to only having one tier which covered both primary and specialty services?
1 vote
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