Common use of PROGRAM DESCRIPTION AND OBJECTIVES Clause in Contracts

PROGRAM DESCRIPTION AND OBJECTIVES. The DSHP section 1115(a) demonstration is designed to use a managed care delivery system to create efficiencies in the Medicaid program and enable the extension of coverage to certain individuals who would otherwise be without health insurance. The initial demonstration was approved in 1995 to mandatorily enroll most Medicaid recipients into managed care organizations (MCOs) beginning January 1, 1996. Using savings achieved under managed care, Delaware expanded Medicaid health coverage to uninsured Delawareans with incomes up to 100 percent of the federal poverty level (FPL) and provides family planning coverage to women losing Medicaid pregnancy coverage at the end of 60 days postpartum or losing DSHP comprehensive benefits and have a family income at or below 200 percent of the FPL. The demonstration was previously renewed on June 29, 2000, December 12, 2003, December 21, 2006, and January 31, 2011. Through an amendment approved by CMS in 2012, the state was authorized to expand the demonstration to create the Diamond State Health Plan Plus (DSHP-Plus) to mandate care through MCOs for additional state plan populations, including (1) individuals receiving care at nursing facilities (NF) other than intermediate care facilities for the mentally retarded (ICF/MR);