CHIPRA Can Help Improve Health Care for Non-English Speakers

Home 9 Family Economic Security 9 CHIPRA Can Help Improve Health Care for Non-English Speakers

The Children’s Health Insurance Program Reauthorization Act (CHIPRA) approved by Congress early this year gives states financial assistance and policy options that will help Wisconsin improve Badger Care Plus. One source of financial assistance is an enhanced federal match rate for interpretation and translation services.

The new rate, which is 75% for children in Medicaid (and potentially slightly higher for kids covered by CHIP), applies to translation and interpretation services needed to assist children in applying for coverage or at renewal, or when care is being provided. Like some of the other parts of CHIPRA, this is an area where there is still some uncertainty, but it’s important to start thinking about how WI can take advantage of the increased federal funding for these services.

Initially, it was unclear to me whether or to what extent the higher federal matching rate would help states like WI that primarily use managed care, since the HMOs generally get one flat rate for each enrollee, rather than reimbursement for each service. However, after preliminary conversations with DHS staff and other experts, and after recent guidance from the Centers for Medicare and Medicaid Services (CMS), it appears that there are at least 4 sorts of ways that the higher matching rate for translation can be of assistance in WI:
• to translate outreach documents;
• to help support bilingual workers who assist with applications or renewals;
• to improve communications with non-English speakers when kids are receiving fee-for-service care, such as emergency Medicaid services; and
• to provide increased federal reimbursement (to the state) for spending attributable to interpretation services provided by managed care organizations when caring for children.

In recent weeks CMS has issued several documents that provide guidance to states on how CHIPRA will be interpreted and how states can take advantage of it. One of those, issued on Sept. 3, is a Q & A format document that addresses – among other issues – the matter of how the enhanced federal match for interpretation services will apply to managed care organizations. At question # 9, CMS says:

“States will be permitted to claim the enhanced match for that portion of the capitation rates paid to MCEs that can be documented as attributable to the cost of translation and interpretation services under the contract. CMS will work with States to develop an allowable methodology to collect the information necessary to claim this higher matching rate for the eligible portion of their managed care payment rates.”

All of the CHIPRA guidance can be found on the CMS website. Some of the other documents and topics include the following:
• The September 3 Q & A document expands upon previously released information about the new option for states to provide CHIP coverage to targeted low-income pregnant women.
• An August 31 letter focuses on the provisions in CHIPRA that are intended to ensure immediate coverage up to age 1 for newborn babies born to mothers who are enrolled in Medicaid or CHIP.

Unfortunately, we are still waiting for CMS guidance on what I consider to be the most pressing CHIPRA concern in WI: what specifically do states have to do to become eligible for performance bonus funding by increasing enrollment of children and meeting 5 of the 8 CHIPRA standards for improving enrollment and retention? Wisconsin seems to come close to meeting 5 or 6 of those standards, but there are many unanswered questions about what it will take to meet some of those standards. Once there is any news on that, I’ll share it via this blog and will update WCCF’s CHIPRA implementation checklist.

Topics
Search

Enter your search term and select the types of content you’d like to see to search our entire Multimedia Library.

Sign up for Emails

Your address helps us identify your legislators and the most relevant messages to send you.