Medicaid Rules On Managed Care Could Put Power Of Reform In States’ Hands
New federal proposals show some of the challenges for states as Medicaid managed care operations grow. Also news on Medicaid from Iowa, New York, Kansas, Oklahoma and Michigan.
Modern Healthcare:
Major Medicaid Managed-Care Reforms Hand The Ball To States. Will They Run With It?
The key word defining the first significant federal changes to Medicaid managed care in 14 years is “flexibility”—for states, that is. The CMS laid the responsibility of ensuring that some of the country's poorest residents receive timely, high-quality care to the 39 states and the District of Columbia that contract with private managed-care plans to provide Medicaid services. But those states will need money, manpower and some detailed direction to implement the provisions of the sweeping Medicaid managed-care rule. And some states are more prepared than others to meet the challenge. That could lead to disparities in the improvements to healthcare quality and access the regulations seek to achieve. (Herman and Muchmore, 4/30)
Modern Healthcare:
Medicaid's Unmanaged Managed Care
Regulators and outside auditors will now put more Medicaid insurers under the microscope to ensure federal and state taxpayer dollars are not wasted—the central reason that states moved to managed care in the first place. Some companies will emerge as bigger targets than others. UnitedHealth Group, the parent of UnitedHealthcare, which was tagged for excess payments in Rhode Island, and a number of other major insurers keep their Medicaid medical spending hidden from public view. A suggested medical-loss ratio may now force those payments into the open and help state officials set their rates for insurers. (Herman, 4/30)
The Des Moines Register:
Medicaid Shift Brings Lots Of Hassles, Few Catastrophes
Iowa’s shift to private Medicaid management has sparked aggravation and angst among some patients and health care providers, but even critics acknowledge most participants have continued receiving crucial services as the bugs get worked out. (Leys, 4/30)
The Associated Press:
New York Governor: Give Medicaid To Inmates Before Release
New York's governor is seeking federal approval to extend Medicaid coverage to inmates who face serious health challenges immediately before they're released from prison. Andrew Cuomo's office announced Friday that the state is the first in the nation to make such a request. The Democratic governor says that too many inmates leave prison with serious mental health and addiction challenges and that helping them get the care they need improves their chances of successfully re-entering society. (4/29)
The Kansas Health Institute News Service:
Budget Proviso Would Delay Medicaid Waiver Integration
Legislative budget negotiators have agreed to insert a provision in the state budget preventing Gov. Sam Brownback’s administration from consolidating Medicaid support services for Kansans with various disabilities. The Medicaid waiver integration plan has been a point of contention between the administration and a legislative subcommittee appointed to study the issue. The subcommittee issued a report recommending the integration be delayed a year to Jan. 1, 2018, and requesting more details on the plan. (Marso, 4/30)
The Associated Press:
Tobacco Tax For Medicaid Plan Faces Challenge In Oklahoma
A plan to shift coverage for some of Oklahoma's Medicaid recipients in order to trigger an infusion of federal funding appears to be gaining support among Republican lawmakers, but the idea of funding it with a tobacco tax is facing uphill sledding in the GOP-controlled Legislature. The Medicaid Rebalancing Act of 2020 was unveiled this spring by state health officials as an alternative to a Medicaid expansion under the Affordable Care Act, which has been fiercely opposed by Republican lawmakers for years. The proposed plan involves shifting about 175,000 pregnant women and children off Medicaid and into private insurance plans, which would be purchased with subsidies through the federal marketplace. (4/30)
Detroit News:
Lawmakers Slow Medicaid Expansion In Flint
Two months ago this week, the federal government approved Gov. Rick Snyder’s request to extend Medicaid health insurance to another 14,000 Flint children and 1,000 pregnant women who may have been exposed to toxic lead through the city’s tainted drinking water. But the health care coverage has yet to be activated because it requires approval of the state Legislature, where the wounds of a divisive 2013 Medicaid expansion battle still linger. (Livengood, 5/1)