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The purpose of the Division of Medicaid and Medical Assistance is to provide health care coverage to
individuals with low incomes and those with disabilities and to ensure access to high quality, cost effective
and appropriate medical care and supportive services.
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- Diamond State Health Plan 1115 Waiver Renewal
Delaware Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA) intends
to file an application with the Centers for Medicare and Medicaid Services (CMS) to request a five-year
extension of the Diamond State Health Plan 1115 Demonstration Waiver, which is scheduled to expire on
December 31, 2013. Under a waiver of Section 1115(a) of the Social Security Act, the Diamond State Health
Plan (DSHP) implemented a mandatory Medicaid managed care demonstration program statewide on January 1,
1996.
Goals of the DSHP are to improve and expand access to healthcare to more adults and children throughout
the State, create and maintain a managed care delivery system emphasizing primary care, and to strive
to control the growth of healthcare expenditures for the Medicaid population.
The Division of Medicaid and Medical Assistance (DMMA) proposes to hold two (2) Public Hearings on the
Diamond State Health Plan 1115 Demonstration Waiver Renewal Request. The hearings will include an overview
of the status of the current program, the program objectives, Diamond State Health Plan 1115 Demonstration
Waiver Renewal Request concepts and the federal waiver process. To view the Waiver application, go to
the 1115 Waiver Renewal page.
- DMMA Disproportionate Share Hospital Application Process
Under Medicaid's Disproportionate Share Hospital program (DSH), DMMA is authorized to make annual
lump-sum supplemental Medicaid payments to qualified Delaware-based hospitals which serve a disproportionate
share of Medicaid and low-income patients. Qualifying hospitals must have inpatient facilities located
in Delaware, meet other federal and state requirements and in some cases must also have been enrolled
as providers with DMMA's Managed Care Organizations and the Medicaid fee-for-service program in the
consecutive 24 months immediately preceding the month of DSH payment.
In this second year of the DSH Program, the DMMA Director, Rosanne Mahaney, announced the process
for hospitals to apply for Medicaid DSH payments based on the hospital's fiscal year ending in 2011.
An acute care hospital wishing to apply must submit a completed DSH application which must be received
by DMMA no later than 4:30 pm Eastern time, Friday, October 12, 2012. For a psychiatric hospital, the
deadline is 4:30 pm, Monday, April 1, 2013. Questions about the DSH application process may be sent to
Frank O'Connor via email at frank.oconnor@state.de.us
or he may be contacted directly at (302) 255-9615. For a copy of the DMMA Director's September 17,
2012 announcement, the DSH application form (DMMA Form DSH 1), and the instructions for completing the
DSH application, go to Disproportionate Share Hospital Application Process page.
- Diamond State Health Plan Plus
The Diamond State Health Plan Plus program began
on April 1, 2012. Under DSHP Plus, Medicaid beneficiaries receiving long term care services (ex.: nursing
facility, home and community-based waiver services, full dual eligibles) are integrated into the Diamond
State Health plan in order to have their care better managed. The Diamond State Health Plan Plus 1115
Waiver Amendment is available for public review going to DSHP-Plus
Waiver. Please go to DSHP - Plus for additional DSHP Plus information.
- Delaware's Consumer-Focused Health Care Reform Website
Under the Affordable
Care Act, health benefit exchanges will be created to provide a web-based means of purchasing health insurance
for individuals and small employers. The Health Benefit Exchanges will be effective as of January 1,
2014. Located on the Delaware Health Care Commission's website is current information about health
care reform and health benefit exchanges. The website includes information about how health care reform
and the exchanges will benefit Delawareans and also contains a link to the State of Wisconsin's health
benefit exchange prototype. The prototype permits consumers to test-drive the application to gain an
understanding of how a well-designed and user-friendly exchange can work. Visit the Delaware Health Care
Commission website at dhss.delaware.gov/dhcc for more information.
- Provider Incentive Program for Electronic Health Records
The Health Information
Technology for Economic and Clinical Health Care Act, more commonly referred to as the HITECH Act, was
enacted as part of The American Recovery and Reinvestment Act of 2009. Section 4210 establishes an incentive
payment program for Medicare and Medicaid providers to encourage the adoption and use of electronic health
records. This program will provide incentive payments to eligible professionals and eligible hospitals
as they adopt and demonstrate meaningful use of certified EHR technology. Eligible professionals may receive
up to $63,750 over 6 years and eligible hospitals may receive payments based on a number of factors, beginning
with a $2 million base payment. The Medicaid EHR incentive program is voluntary and began in calendar
year 2011. The Division of Medicaid & Medical Assistance participates in this program. Providers can
register with CMS and apply through the Delaware Medical Assistance Program (DMAP). We encourage providers
who are considering an investment in EHR technology to evaluate their eligibility for this program and
their ability to meet the proposed requirements in order to qualify for the incentive payments. For more
information, go to Delaware Medical Assistance
Program (DMAP).
- List of Medicaid Participating Dentists Now Available
Comprehensive dental care
is a benefit for children and adolescents through the Delaware Medicaid and CHIP Programs. DMMA has compiled
a list of enrolled dentists and it is now posted at the following website:
www.dmap.state.de.us/information/DE_participating_oral_health_providers.pdf
Click on the link and print off the list to help locate a dentist in your area who can treat your Medicaid
or CHIP eligible child. Once you have made an appointment with a dentist who will care for your child,
be sure to keep that appointment. Missed appointments prevent your child from receiving the vital oral
health care he/she needs and can cause difficulty with making your next appointments.
- Medicaid for Workers with Disabilities (MWD) Starts
Operation
The Medicaid for Workers with Disabilities (MWD) program was implemented
by the Division of Medicaid and Medical Assistance on October 1, 2009. This program is intended to assist
individuals with disabilities by allowing them to work without losing health benefits. Individuals with
countable income below 275% of the Federal Poverty Level (FPL) may be eligible. Cost sharing, in the
form of monthly premiums, will be applied to those with incomes exceeding 100% of FPL. For more information
and an application please call (302) 255-9500 or 1-800-372-2022
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Last Updated:
Tuesday April 30 2013
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