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News & Press: Advocacy

Public Concerns Will Lead To Proposed Medicaid Rule Change

Tuesday, January 9, 2018   (0 Comments)
Posted by: Allan Wachendorfer
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Monday, November 20, 2017

Public opposition to a proposed Department of Health and Human Services rule that the public said could make it harder for those addicted to opioids to get needed counseling and support will be changed to meet those concerns, a DHHS spokesperson said Monday.

The proposed rule from the DHHS's Medical Services Administration, which was drafted after a directive was issued by the federal Centers for Medicare and Medicaid, was even opposed by a separate division of DHHS, the Behavioral Health and Developmental Disabilities Division.

Geralyn Lasher, a spokesperson for the department, said because of the large number of comments complaining about the proposed rule the department will make changes.

The last day for the public to comment on the rule was Monday and changes will be written for the proposed rule, Ms. Lasher said.

The rule dealt with which Medicaid providers would be considered unfit to provide services and be reimbursed and is a way of trying to limit substance abusers from becoming providers. Among other things, the rule would prevent anyone who had been convicted of a felony or a misdemeanor that included possession, delivery and manufacturing of drugs from being considered an eligible Medicaid provider. Theft and prostitution, which addicted persons have sometimes turned to, are also among the offenses that could keep someone from being an approved Medicaid provider.

But that, opponents said, could limit the ability of persons trying to shake opioid addictions from getting help from peer counselors, men and women who themselves had suffered from opioid additions. Mark McWilliams of the Michigan Protection and Advocacy Service said that reports "from the field" indicated that many opioid counselors "have a history."


And Allan Wachendorfer, with the National Association of Social Workers, said that "the best people to provide support to those with mental illnesses and those battling substance issues are people who have similar experiences.


Elmer Cerano, executive director of the Michigan Protection and Advocacy Service, said in a letter to the department that the rule should be aimed at people with substantial histories of financial exploitation, abuse or neglect or abusing the Medicaid system.


Instead, he said, "the proposed policy goes beyond the law and guidance to exclude providers with nearly any criminal history, including shoplifting, crimes committed by juveniles and drug possession."


And because the policy also grants a broad waiver of its rules to those who work in home help services, it renders "the expanded scope of the policy pointless for the most vulnerable people."


The DHHS's Behavioral Health and Developmental Disabilities said in its opposition that if peer counselors are blocked because of previous criminal activity, "Beneficiaries served will be personally impacted by losing the choice of a peer provider."


Mr. McWilliams said opposition to a proposed departmental rule by another division of the department is something, "you don't see very often."


And Ms. Lasher said peer-to-peer counseling is "incredibly important" to helping curb opioid abuse. The final policy, she said, will reflect the concerns others expressed.

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