Poverty and Public Health
5:28 pm
Thu February 14, 2013

Centennial Care Tribal Opt-Out Clears Committee

A bill that would allow Medicaid eligible tribal citizens in New Mexico to opt-out of the states Medicaid plan, Centennial Care, has taken it’s first steps in the legislature. HB 376, which gives Native Americans the ability to opt-out of Centennial Care has passed out of committee.

Under the states proposed Medicaid program entitled Centennial Care, all Medicaid enrollees in the state would be required to enroll in one of four managed care organizations (MCO) to receive healthcare.

For New Mexico’s tribal population, this proposal is causing problems.

Currently, Native American Medicaid enrollees can receive services from the Indian Health Service (IHS), tribal clinics, or urban Indian clinics – and the state reimburses those providers for services promptly.

Under Centennial Care, Native Medicaid users would be mandated to enroll in a managed care organization, could still use an IHS service, but the Service would then have to bill the MCO for services instead of the state, which could cause hang ups for service reimbursement.

Beyond that, Regis Pecos, Chief of Staff to the Majority floor leader, says there’s been very little incentive for MCO’s to reach out and partner with Tribal health providers. Under Centennial Care, Medicaid money would be paid per-person, per-month ahead of time to MCO’s, and Pecos says the less Native people that use the plan, the better it is for the company.

"Tribes don’t want to see 31-million dollars a month go into a system regardless of whether they receive a service or not they get that windfall,” says Pecos. “They get the money whether Indian people access that MCO or not and the less that they access, the windfall to those MCO’s.”

Pecos says he hopes that if Native Americans have a right to choose how they receive healthcare, MCO’s and the Indian Health Service will be able to work in concert, instead of clashing.