Bureau for Medical Services Story Archives - West Virginia Public Broadcasting

Lawmakers Hear Updates On DHHR Reorganization

The three appointed secretaries of the new bureaus of the DHHR provided lawmakers with updates on restructuring within the department. Legislation passed in 2023 required the department to be reorganized and split into three agencies after concerns of inefficiencies in the system.

Members of the Legislative Oversight Commission on Health and Human Resources Accountability voiced concerns about the restructuring of the Department of Health and Human Resources on Tuesday.

The three appointed secretaries of the new bureaus of the DHHR provided lawmakers with updates on restructuring the department. Legislation passed in 2023 required the department to be split and reorganized after concerns of inefficiencies in the massive agency.

The new secretaries are Dr. Sherri Young, incoming secretary of the Department of Health, Dr. Cynthia Persily, incoming secretary of the Department of Human Services and Michael Caruso, incoming secretary of the Department of Health Facilities.

Young said and her fellow secretaries are identifying critical vacancies in their departments and consolidating some empty positions.

“We have met with our respective new departments, within our bureaus and offices so that we can better understand what needs they have as far as critical vacancies and what positions need to be filled, and how we could be more administratively responsible with the positions that haven’t been filled for quite some time,” she said.

Young also reported a decrease in vacancies in the Bureau for Social Services, the Bureau for Child Support Enforcement, the Bureau for Medical Services and the Bureau for Behavioral Health.

However, the Department of Health Facilities, the Bureau for Public Health and the Bureau for Family Assistance increased in vacancies.

Caruso explained the problem in his presentation.

“Basically, we don’t pay our people enough on an hourly rate,” Caruso said. “All right, and neither does the rest of the systems. The fact is that most of our employees have just jumped to the contracted services.”

Caruso also reported that he brought in Baker Tilly US, LLP, an advisory, tax and assurance firm, to do a benchmark study on all facilities and perform a complete financial review.

“Those studies were completed last week, those studies will be integrated, and we will educate our leadership team as well as our CEOs over the next week and a half,” Caruso said.

Health Management Information Systems, or HMIS, are software used to manage and analyze healthcare data. Caruso said he is looking to improve the Department of Health Facilities’ HMIS.

“We are looking internally to improve that process and improve that program, as well as potentially looking at other outside vendors to cover our emergency or electronic medical records,” Caruso told lawmakers.

Persily reported a reduced vacancy rate in the Department of Human Services and accredited that to pay raises and access to behavioral health services for Child Protective Services workers.

“So the work that you did in the last session, to increase salaries, to provide regional salary differentials, it’s worked. We have reduced significantly the vacancies in that particular job classification,” Persily said. “I believe that in January last year, when you heard about this, the rate was about 30 percent. And our rate at the end of July was 17 percent.”

Lawmakers questioned the secretaries on their proposed structuring of the departments, voicing concerns about the level of bureaucracy operating in the agency.

Del. Amy Summers, R-Taylor, asked the secretaries to be proactive instead of reactive in their planning.

“My only concern is I don’t want to duplicate what we’ve been doing when we have this great opportunity to create something new,” Summers said.

Persily said she and the other secretaries will have a model in place by January 1, 2024, the deadline for the department to split, but advocated for flexibility.

“We are not going to be wedded to a model if it doesn’t work, and we will constantly be improving that model as we move along. And so any changes would be for efficiency, and for functionality,” Persily said. “But what I will say is that you will, you will see some consistencies across the three departments, you will see that we there are some things that each department needs.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

State Official: Medicaid Court Order to Cost State Millions

A state official says a court order regarding Medicaid managed care contracts will cost West Virginia millions of dollars.

Bureau for Medical Services acting commissioner Cindy Beane says the order also could affect delivery of services to some Medicaid recipients.

Beane says in a statement that the bureau and the Department of Health and Human Resources are weighing their legal options.

The Charleston Daily Mail reports that a Kanawha County judge granted a preliminary injunction on Tuesday barring the addition of mental health services to Medicaid contracts with health maintenance organizations without competitive bidding. The expanded coverage is set to begin July 1.

Five West Virginia taxpayers requested the injunction in an April petition. They argued that the contracts are illegal because the DHHR awarded them without competitive bids.

W.Va. Officials Launch Behavioral Health Program

West Virginia officials are launching an initiative to help Medicaid members with behavioral health diagnoses live healthier and happier lives.

The West Virginia Department of Health and Human Resources Bureau for Medical Services said it launched the Health Homes initiative for behavioral health on July 1.

As part of the program, a team of professionals coordinates to help manage medical conditions and medications, remember doctor appointments and understand medical tests and results. Teams will also work with doctors, counselors and specialists to support recovery and prevent other illnesses or complications.

The program is available in Cabell, Kanawha, Mercer, Putnam, Raleigh and Wayne counties. Officials say those locations were selected because of the high rates of individuals who are already being treated for behavioral disorders.

Audit: W.Va. at Risk of Losing Medicaid Funds

Legislative auditors say West Virginia is at risk of losing millions of dollars in federal Medicaid funding because state hasn’t complied with a 2011 directive.

The directive requires states to suspend Medicaid payments to health care providers if fraud allegations are determined to be credible.

A legislative audit says Medicaid has paid at least $17.9 million to providers whose cases were referred to the state’s Medicaid Fraud Unit. The payments could be as a high as $211 million.

The audit was released Tuesday during legislative interim meetings.

Bureau for Medical Services counsel Alva Page told lawmakers that the bureau and auditors have different interpretations of the applicable portion of the Affordable Care Act.