Florida House Approves Expanding Medicaid Managed Care; Kansas Weighs Proposal To Raise Nursing Home Fees

Health News Florida: "Calling the current system 'broken' and warning of long-term financial problems, the state House today approved a proposal that would gradually shift almost all Medicaid recipients into managed-care plans. The votes on two bills set the stage for the House and Senate to try to reach agreement on a Medicaid overhaul before the annual legislative session ends April 30. The Senate has passed a different Medicaid managed-care bill that would expand a five-county pilot program to 19 additional counties. In a last-minute change today, the House delayed until 2012 a requirement that managed-care recipients in Miami-Dade County enroll in managed-care plans --- after earlier setting a June 30, 2011, deadline. House leaders planned to expand the pilot program into Miami-Dade as the first step in a five-year process of requiring managed care" (Saunders, 4/19).

News Service of Florida/Health News Florida: Regarding Florida's state health budget, "When House and Senate budget conferees finally huddled Monday, the House won the first skirmish by getting the Senate to adopt an austerity approach that assumes little or no extra Medicaid funding will be approved by Congress. ... While such big-ticket items as the state's Medically Needy program and Medicaid aged and disabled services appear set for continued funding, based on allocations Monday, the Senate may be harder pressed to find the dollars needed to avoid House-backed cuts in substance abuse, mental health and developmentally disabled programs. Hospitals, nursing homes and HMOs also look likely to have state payments reduced, a stance embraced earlier by both the House and Senate" (4/19).

Kansas Health Institute: "State officials haven't yet fully gauged the consequences of reducing in-home services for the elderly" but last November Kansas Gov. Mark Parkinson "ordered a 10 percent cut in the state's Medicaid rates. ... Parkinson at the time said the decision was bad public policy but revenue shortfalls left no choice. He proposed raising taxes to restore the Medicaid cuts and stave off more cuts to education and social service programs and has been waging a campaign to convince the public and legislators to go along. ... Within Medicaid, in-home services are considered optional and may be cut; nursing home services are an entitlement and must be provided" (Ranney, 4/13).

The Associated Press/Kansas City Star: "Operators of nursing homes and assisted living centers in Kansas are deeply divided over a proposal to charge a fee for every bed in their facilities in an effort to attract more federal money. A bill awaiting legislative action would assess a $1,325 fee per bed in nursing facilities. It would collect an estimated $27 million from nursing facilities, which could be matched by about $62 million in federal dollars. Supporters say the extra funds would help a system struggling with deep budget cuts, while opponents argue that lawmakers would likely use the money for other purposes to help fill a serious budget gap. Phyllis Kelly, executive director of the Kansas Adult Care Executives association, said nursing home administrators and assisted living operators generally are united on most issues. But this proposal is so divisive that her organization is not taking a position on it" (4/19).

Public News Service: "Arizona lawmakers have yet to act on restoring funding for KidsCare, the state's health insurance program for children of the working poor. ... State House Democrats have proposed raising the needed $21 million for KidsCare by expanding the sales tax to cover extended warranties on such items as TV sets. ... Governor Jan Brewer is joining a lawsuit against the feds, hoping to overturn the requirement that the state maintain its funding levels for federal health programs. Kidscare, which covers about 38,000 Arizona children, is currently scheduled for elimination in less than two months" (Ramsey, 4/20).

The Roanoke Times: "Some mental health advocates are urging Virginia lawmakers to reject two budget amendments from Gov. Bob McDonnell, arguing that they could restrict access to psychiatric drugs and further strain underfunded community-based mental health services. As part of his proposed revisions to the state's two-year budget, McDonnell is seeking authorization to expand the managed care program under Medicaid and have it cover community mental health and substance abuse services and residential treatment. Those services are carved out of the existing, limited Medicaid managed care program. McDonnell also wants to add behavioral health drugs to the Medicaid Preferred Drug List, a proposal that lawmakers have shot down in previous administrations. McDonnell's administration wants to expand managed care statewide for virtually all Medicaid services in an effort to contain costs and prepare for federal health care reform mandates, which will increase eligibility for the Medicaid program that serves the poor, elderly and disabled beginning in 2014" (Sluss, 4/20).

Wisconsin State Journal: "A new tax on Wisconsin's rural hospitals will offset a state Medicaid cut and increase incentives for doctors and other health care providers to work in rural areas. ... A bill signed Monday by Gov. Jim Doyle authorizes the tax on ... 'critical access' hospitals, all in rural areas. The new measure is similar to a tax adopted last year on the state's 72 nonrural hospitals. The rural hospital tax, of about 1.6 percent of patient revenues, will bring in about $10.6 million a year in additional federal matching funds from Medicaid, the state-federal health plan for the poor. The extra money will offset a state Medicaid cut of about $7.5 million a year to the rural hospitals, part of $625 million in planned reductions over two years to the recession-strained program" (Wahlberg, 4/19). 

Milwaukee Journal Sentinel: "The tax, modeled after a similar tax placed on larger hospitals last year, will draw millions of dollars in federal money at a time when the state struggles with budget deficits. ... The bill also sets aside $750,000 from the hospital tax for the University of Wisconsin School of Medicine and Public Health to create a family medicine residency program at rural hospitals. Doctors often practice in areas where they have done their residency. The money would fund five to seven slots. In addition, the bill provides $250,000 to double the maximum amount available to repay the school loans of doctors who practice in rural areas, increasing it to $100,000 from $50,000" (Boulton, 4/19). 

Chattanooga Times Free Press: "Most of the projected $1.12 billion in new TennCare costs the Bredesen administration says state government will incur under federal health care reform stems from the state having to pay for people who now qualify for TennCare but aren't in it, administration officials say. The federal reforms are expected to have a 'woodwork' effect that state officials believe will drive an estimated 60,625 now TennCare-eligible Tennesseans into the program between 2014 and 2019. That accounts for $913 million, or 81.1 percent, of the overall increase the reforms are expected to have on TennCare, the state's version of Medicaid, according to TennCare Bureau figures. By comparison, the other 181,666 Tennesseans who will become newly eligible under expanded Medicaid eligibility standards in the new federal law will account for just $199 million of the cost over the five-year period, bureau figures show" (Sher, 4/20).

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