Oct. 25, 2017: Medical Assistance Advisory Council Briefed on Range of Medicaid Topics


The Division of Mental Health and Addiction Services and the Division of Medical Assistance and Health Services (DMAHS) discussed key areas of substantive work with the Medical Assistance Advisory Council (MAAC) at Thursday’s quarterly meeting. 

Assistant Mental Health and Addiction Services Commissioner Valerie Mielke updated the MAAC on the progress being made to integrate the Division into the Department of Health. The integration was put into effect by Governor Christie with the goal of addressing regulatory and other barriers to the more seamless coordination and oversight of mental health and addiction services. Further discussion of the integration and its effect on collaboration with the Department of Children and Families and the Division of Developmental Disabilities within the Department of Human Services will occur at the January MAAC meeting.

DMAHS reported on the following key initiatives:

  • DMAHS continues to work with the Centers for Medicare and Medicaid Services on finalizing the standard terms and conditions under the comprehensive Medicaid waiver related to the continuum of benefits for substance use disorder treatment and the Institution for Mental Disease (IMD) exclusion. DMAHS has sought waiver authority to claim expenditures for services provided in a residential facility that meets the requirements of an IMD for individuals 18 and older for non-hospital based withdrawal management (ASAM3.7 WM), short-term residential treatment (ASAM 3.7) and long-term residential treatment (ASAM 3.5). Under this authority, the state must maintain a combined average length of stay of 30 days or less for these services to receive federal matching funds.
  • In addition, DMAHS is planning to obtain more stakeholder feedback related to the adult intellectual developmental disability program and is evaluating the efficacy of expanded waiver authority to permit attestation of eligibility for individuals up to 300 percent of the federal benefit rate.
  • This December, DMAHS plans to launch the online version of the Medicaid financial eligibility application for the aged, blind and disabled population. This will enable applicants to fill out their application, upload required information and submit the package to the county welfare agency or board of social service electronically. This system also provides DMAHS with the ability to monitor application processing.
  • The asset verification system is in use by the counties. This system enables case workers to access financial information electronically to ensure that individuals are truly eligible for Medicaid benefits in a more timely manner than collecting physical documents and navigating different data sources.
  • A review of the child core set measures under Medicaid and CHIP was provided. The number of measures available for use has steadily increased over the last few years. Some measures where performance is at a very high level have been retired over time. In 2017, 27 measures are available for reporting, and New Jersey anticipates reporting on 18 of them. More information is available on the Medicaid website.
  • A thorough review of the new three-year contract awarded to Logisticare for transportation broker services for non-emergency medical transportation was provided. The contract period began September 2017 and will extend through September 2020, but the state has two one-year options to extend after 2020. Discussion included statistical breakdown of trips, complaints and reasons for trip cancellations. Key contract changes for this period include live GPS tracking of vehicles, classroom and behind the wheel training requirements, reduction in “will call” pick up time to 60 minutes and handling of complaint responses. The state has a monitoring unit to oversee Logisticare, including two full-time onsite staff currently. DMAHS intends to increase this to five full-time staff plus more field staff and a full time registered nurse.
  • Updated statistics for Medicaid enrollment statewide and for managed long term services and supports were provided. Of note is that Aetna Better Health is now statewide and WellCare is operating in 17 counties.

All of the MAAC presentations will be made available on the Department of Human Services’ website.