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Regulation and Compliance > State Regulation

Louisiana official blasts HHS PPACA delays

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Problems with getting the U.S. Department of Health and Human Services to answer questions about federal health law details have jacked up implementation costs, a state official testified today.

The official, Kathy Kliebert, secretary of the Louisiana Department of Health and Hospitals, spoke at a hearing on state implementation of the Patient Protection and Affordable Care Act (PPACA) that was organized by the U.S. House Oversight and Government Reform health care subcommittee.

Getting a response from HHS on important questions can take three to four months, Kliebert said.

“We cannot afford to wait months for these answers,” Kliebert said.

Kliebert cited efforts to get HHS officials to help state Medicaid programs adopt a new income eligibility testing standard — a “Modified Adjusted Gross Income” standard — as an example of a result of the delays.

Most states have to revamp their Medicaid eligibility systems to shift to the MAGI standard.

Federal officials promised in March that HHS would develop a “MAGI in a box” solution that would be free to the states.

Instead, Kliebert said, HHS officials said in June, during a conference call, that the states would have to develop their own MAGI implementation systems instead.

That shift is forcing Louisiana to spend about $750,000 on 5,437 in additional contractor work, Kliebert said.

Kliebert also questioned how well HHS has trained the call center workers supporting exchanges in states like Louisiana that are letting HHS run their public exchange programs.

A call center worker told one Louisiana man that many states are expanding Medicaid eligibility, and that the man should call the Louisiana Medicaid program to see if it was one of those states, even though Louisiana is one of the states that has definitely rejected Medicaid expansion, Kliebert said. 

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