The Med-QUEST Division hereby notifies the public that a post-award forum will be held to afford the public with an opportunity to provide meaningful comments on the progress of the 1115 demonstration project.

2018 Annual Plan Change

View the latest Med-QUEST news, events, notices, meetings, hearings, updated information, and more for 2018.

Aloha! To prepare for and address severe weather conditions resulting from Hurricane Lane, and for the safety of our staff, the Hawaii MedQUEST Division Offices will be closed on August 23, 2018 and August 24, 2018. We anticipate reopening for regular business on Monday, August 27, 2018, pending weather-dependent updates from the Governor’s office over the weekend (for the latest updates, please visit https://governor.hawaii.gov/newsroom/). We do apologize for any inconvenience this may cause, and look forward to serving your needs when we return to the office.

Department of Human Services/Med-QUEST Division to require the use of an Electronic Visit Verification (“EVV”) system for Medicaid-provider personal care services and home health services.

The State of Hawaii, Department of Human Services (the State) is proposing to request approval from the federal Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) to extend the “QUEST Integration” Demonstration Project (Project Number 11-W-0001/9) under Section 1115(a) of the Social Security Act for an additional five years in order to further transform and improve the healthcare delivery system for low-income Hawai‘i residents. The State will request approval of a five-year extension of the 1115 Demonstration (Waiver) beginning January 1, 2019 and continuing through December 31, 2023.

Turn in your unused or expired medication for safe, anonymous disposal. Saturday, April 28, 2018, 10:00 a.m. - 2:00 p.m. New or used needles and syringes will not be accepted.

Department of Human Services, Med-QUSET Division (MQD) and its contractor, Health Services Advisory Group collaborated with public and private stakeholders to build an efficient web-based PASRR compliance system, whereby all individuals will be protected under PASRR to ensure that Long Term Services Supports (LTSS) are provided in the most integrated setting that meets the individual’s need and preferences. The neighbor islands (i.e. Hawaii island, Kauai, lanai, Maui, Molokai) began to use the E-PASRR application on December 11, 2017. Oahu will begin using the E-PASRR application on February 1, 2018. There will be a number of webinar and in-person trainings in January and February 2018.

The State is proposing to request approval from the federal Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) to extend the QUEST Integration Demonstration under Section 1115(a) of the Social Security Act for an additional five years, and to amend the Medicaid State Plan, as appropriate, in order to incorporate specific measures that will further transform and improve the health delivery system for low-income Hawai‘i residents. The State will request approval of a five-year extension of the 1115 Demonstration (Waiver) beginning January 1, 2019 and continuing through December 31, 2024.

On January 22, 2018, Congress reauthorized the Children’s Health Insurance Program (CHIP). Hawaii has always been committed to ensuring our keiki have access to quality healthcare. This reauthorization embodies our shared commitment for caring for our kids. One in four of Hawai'i’s keiki are currently covered by Medicaid.

The Developmental Disabilities Division and Med-QUEST Division will be submitting Amendment #2 to the Centers for Medicare and Medicaid Services (CMS) at the end of February. This amendment will add individual supports budgets, make changes to align nursing services with federal requirements, and adjust some service definitions. The full list of changes is included in the Public Notice document. We value your input and encourage you to review the changes to the waiver amendment that are highlighted in yellow in the 1915(c) HCBS Waiver Amendment #2 . One paper copy of the waiver amendment will be available at each DDD Case Management Unit, as well as at the DDD office located at 1250 Punchbowl, Room 463, Honolulu and the Community Resources Branch office at 3627 Kilauea Ave., Room 411, Honol

Hilopa’a Family to Family Inc. (Hilopa’a) is selected to provide Ombudsman services to Hawaii Medicaid beneficiaries and providers on all islands. Hilopa’a is able to assist in the resolution of issues and concerns about access to, quality of, or limitations to, health care for eligible Medicaid beneficiaries receiving services in Medicaid programs, to include but not limited to QUEST Integration, dental, State of Hawaii Organ and Tissue Transplant (SHOTT) and Community Care Services (CCS) program. Hilopa’a is also able to address concerns from the managed care health plan providers and Fee-For-Services (FFS) providers for the dental and SHOTT programs.

Hawaii’s Home and Community-Based Services (HCBS) transition plan is called “My Choice My Way.” The Department of Human Services (DHS) is partnering with Medicaid waiver participants, waiver families, provider associations, advocates, other State agencies, and other stakeholders throughout this process to develop the plan, receive input, and assure that everyone has access to needed information to assist with transition activities. DHS is committed to engaging with stakeholders through this process and looks forward to receiving feedback. The outcome of this process will be that Medicaid waiver participants will receive services in a way that enables them to live and thrive in truly integrated community settings.

The Affordable Care Act (42 CFR Part 455, subpart E) requires the State Medicaid Agency, Department of Human Services, Med-QUEST Division (MQD) to perform more comprehensive screening, credentialing and enrollment for all Medicaid providers in effort to enhance Medicaid fraud prevention. Providers are identified as “high”, “moderate” and “limited” risk levels. The 21st Century Cures Act has set a compliance deadline of January 1, 2018 for these requirements.

The Med-QUEST Division QUEST Integration Annual Plan Change (APC) choice period is from October 1, 2017 to October 31, 2017. The five (5) available health plans serving QUEST Integration members are AlohaCare, HMSA, Kaiser Permanente, ‘Ohana Health Plan, and UnitedHealthcare Community Plan. Kaiser Permanente QUEST Integration is ONLY available on Oahu and Maui. Your new health plan will take effect on January 1, 2018. If you do not want to change your health plan, do not return the plan change form. You will remain in your same health plan as long as you remain eligible. To make a health plan change, you have three (3) options: Complete the Choice Form and Mail it to: Med-QUEST Enrollment Services P.O. Box 700190 Kapolei, Hawaii 96709-0190 Complete the Choice Form and Fax it to: 1-800-576-5504 Call Med-QUEST Enrollment Services Section at: 1-800-316-8005 Press "0" to speak with a call center representative. Mail will need to be postmarked by October 31, 2017 and fax must have date/time stamp of October 31, 2017.