By: Catherine McKee, Jane Perkins, and Jennifer Lav
Executive Summary
In comments to the Department of Health and Human Services, the National Health Law Program explains that the initial purpose of the Primary Care Network project, which started nearly 20 years ago as a way to expand coverage to population groups that were not described in the Medicaid Act at that time, has been lost. Currently, the project is a hodgepodge of features, many of which restrict coverage and access to care. As a result, we recommend that CMS take the following steps in response to Utah’s application: Where possible, CMS should require Utah to implement elements of the project through other authorities (the state plan or non-demonstration waiver authorities). CMS should then evaluate the remaining elements of the project in accordance with section 1115.
