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CFI enrollment below projections and nursing‑facility backbilling drive higher nursing payments; lawmakers discuss managed care transition
Summary
DHHS officials told Finance Division 3 that Choices for Independence (CFI) enrollment is below earlier projections and that recent nursing facility ownership changes and billing issues led to large backbills and higher nursing payments; committee members discussed, without deciding, whether to transition long‑term services into managed care.
Department officials told Finance Division 3 on March 10 that the Choices for Independence (CFI) waiver serves about 4,161 people while three‑month averages show about 3,688 individuals in nursing facilities; they also described a spike in nursing facility payments driven in part by backbilling and ownership changes.
Melissa Hardy said the CFI waiver (a 1915(c) Medicaid in‑lieu‑of nursing facility program) serves about 4,161 people, while nursing facility census averages approximately 3,688 people over a three‑month period. When lawmakers asked about projections tied to the CFI waiver, Hardy said the department would explain variances to the federal…
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