Enhancing Veteran Benefits through PARIS: Training Conference Highlights

Explore the 2020 PARIS Training Conference focusing on the Veteran Benefit Enhancement Program, PARIS data utilization for veteran outreach, and the need for increased awareness on veteran benefits. Learn about current veterans' benefit claims, income verification strategies, and leveraging VA file data to reduce costs and improve services.

• Veteran benefits
• PARIS
• Outreach
• Conference
• Benefits awareness

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1. Veteran Benefit Enhancement Program and Public Assistance Reporting Information System (PARIS) 2020 PARIS Training Conference March 11-12 2020

2. Introductions Bill Allman WA State HCA President, PARIS Board Tim Dahlin WA State HCA Member, PARIS Board 2

3. In Todays Session Veterans Benefit Enhancement (VBE) Program History and Overview How PARIS data identifies referrals for military related benefits How the program leads to State Medicaid Savings while facilitating veteran outreach 3

4. Why It is Needed Veteran Outreach Over half of the nation s veterans and survivors have little or no understanding of veteran benefits. The following link is an article from McClatchy DC that outlines the challenges in Veteran outreach: http://www.mcclatchydc.com/news/nation- world/national/article24740527.html GAO VA Benefit Awareness Report http://www.gao.gov/products/GAO-12-153 Skyrocketing Medicaid expenditures - 25% to 50% of medical costs can be absorbed by a Veteran benefit o Greater impact Long Term Care programs 4

5. Veterans File Basics Current Veterans Benefits (Claims) for clients o Includes Terminated and Suspended Claims o Not all veterans and survivors; only those with claims Data from the Veterans Benefit Administration (VBA) o Last Paid Date included Matches with the Beneficiary SSN o Apportionments (to spouse, child) listed under Beneficiary 5

6. Veterans File Utilization Income verification - Other Sources (pension claims) - Unreported? Health insurance identification - CHAMPVA, also TRICARE in some cases - Veterans Health Care Maximize VA payments - Proper pension rate - Aid & Attendance (Long Term Care) 6

7. Income Verification Increase accuracy Decrease process time Reduce paperwork Increase organizational knowledge VA pension calculations Aid and Attendance Increase identification of clients with VA income 7

8. Leverage VA File Data to Avoid Costs I Match to current Medicaid recipient data Living Arrangement, Marital Status, Program Full VA nursing care coverage for some veterans 70%+ service-connected compensation Payee Type, Award Line Type, Combined Degree Special service-connected compensation claim Vietnam veterans with diagnosis in Agent Orange criteria Entitlement Code: 1st position 7 8

9. Leverage VA File Data to Avoid Costs II Reduced pension ($90) not nursing facility or w/ dependent o Award Line IP, IDP o Living Arrangement, Marital Status / Children Terminated Claims o Award Status T o Month of Death (MOD) - Award Line Type C, Payee Type not 00 o Change of Circumstances old claim Aid & Attendance or Housebound Benefit facilitation o Veteran A&A NN o Need significant help with care, ADLs (Long Term Care) Gross Pay 9

10. Aid & Attendance = Third-Party Resource Krueger v. Richland County Social Services : o Post-eligibility calculation to determine recipient's share of cost for long-term care (LTC) medical services o Improper to consider as income Treating aid and attendance allowances as third-party liability payments comports with the principle that "'Medicaid is intended to be the payer of last resort, that is, other available resources must be used before Medicaid pays for the care of an individual enrolled in the Medicaid program.'" 10

11. Aid & Attendance / Housebound Under Medicaid LTC program, client is required to share in the cost of his or her care to the extent of available income. 42 C.F.R. 435.726 Participation includes any third party resources (TPR) available to pay for cost of LTC care TPR not income, but applied post-eligibility to participation Medicaid clients are required to apply for all other benefits available to them as a condition of eligibility. 42 C.F.R. 435.608. (expressly includes veterans benefits) See Cordall v. Department of Veterans Affairs and Social and Health Services, 96 Wn.App. 415, 980 P.2d 253 (1999) 11

12. Developing, Filing VA Claims: Benefits of Partnering with State DVA Improve Client Services to Veterans and Family Members Collaborative Referral Process Reduce Estate Recovery for Veterans and Families Reduce Medicaid LTC related expenditures Share Data to Identify Clients Potentially Eligible for Veterans Benefits 12

13. Partnering with State DVA State Medicaid Agency acts as gatekeeper o Use of VA match and Medicaid data to provide quality referrals Monthly reporting from DVA on claims activity o Claims filed o New Awards o Non-cooperation? PARIS VA file provides additional layer of reporting o New Awards o Aid & Attendance enhancements 13

14. Medicaid Cost Avoidance Medical Costs Avoided for Washington State Over $100M in medical costs avoided in last 12 years Thousands of veterans and families served $25 $20 Millions $15 $10 $5 State Fiscal 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 $0 14

15. Selected As A Best Practice By White House US HHS ACF/CMS NGA National Governor s Association CHCS Center for Healthcare Strategies Governing Magazine Kaiser Health Pew Research Center 2013 Veteran s Administration s Abraham Lincoln Pillar of Excellence Award 2004 Governors Award for Customer Service 15

16. Other States Assisted with Program Implementation Oregon An article on how Oregon has connected Veterans with VA benefits and off of Medicaid: http://blog.oregonlive.com/oregonatwar/2011/08/oregon_prepares_for_pi lot_effo.html A PDF report to the Oregon Legislative Assembly on Veterans Outreach activities in Oregon: http://www.oregon.gov/dhs/assistance/Documents/vets-outreach- legisreport2014.pdf Texas A report on PARIS and VA matching of Veterans with benefits: https://oig.hhsc.texas.gov/sites/oig/files/reports/PARIS-VA-Match-Report- FY-2016.pdf 16

17. QUESTIONS? Bill Allman WA State Health Care Authority Medicaid Office of Program Integrity Veterans Benefit Enhancement Program Phone:(360) 725-1020/725-2077 E-mail: william.allman@hca.wa.gov tim.dahlin@hca.wa.gov Tim Dahlin