Medicaid News: Ga. Working On Reshaping Program

News outlets look at a variety of Medicaid issues in California, Florida, Georgia, Kansas and Wisconsin.

The Atlanta Journal-Constitution: Reshaping Medicaid Care To Affect Many
Georgia is reshaping its Medicaid program, a complex lifeline for 1.7 million vulnerable people that consumes $21 million in state and federal dollars every single day. The state is widely expected to announce a plan this summer that would dramatically expand the use of for-profit insurance companies in a new approach to managing Medicaid. … A consultant's report in January strongly recommended relying on private companies to manage Medicaid. In the months since, the state has quietly convened task forces of key health care providers and advocates to debate the various options, from maintaining the status quo to letting hospitals and doctors manage the care (Teegardin and Williams, 6/3).

The Atlanta Journal-Constitution: Medicaid More Than Medical Aid
People like Francel Kendrick once spent most of their lives locked inside state hospitals. … Medicaid isn’t just a health plan for low-income people. These days, it’s a job training program, relief for a mom with an autistic son and crisis teams to help someone with schizophrenia live a stable life in the community. State health officials who are redesigning the state’s $7.8 billion Medicaid program face an especially tricky task in dealing with recipients who rely on this broad spectrum of services (Williams and Teegardin, 6/4).

Politico Pro: CMS, Walker Fight Over Care Funding
As Wisconsin Gov. Scott Walker's recall vote approaches on Tuesday, he's causing a big headache at CMS. Walker's administration is in a protracted fight with the agency over the renewal of federal funding for a popular long-term care program -- and whether it should reimburse beneficiaries who were shut out for nine months. The program Family Care, operates under a home and community-based services Medicaid waiver and aims to keep elderly and disabled people out of nursing homes. As part of the cost-cutting drive that put Walker in the national spotlight, Wisconsin began severely limiting Family Care enrollment last July (Smith, 6/4).

News Service of Florida/Baltimore Sun: Florida's AHCA Looks At How State Will Recoup Medicaid Costs
With hundreds of millions of dollars at stake, local officials from across Florida are seeking changes as the state moves forward with new plans for collecting Medicaid payments from counties. The issue has become highly controversial, after lawmakers in March required that the Agency for Health Care Administration recoup disputed Medicaid charges to the counties going back more than a decade. As of this past week, 53 counties had joined a pending lawsuit that challenges the constitutionality of the Legislature's move (Saunders, 6/2).

Stateline: Medicaid Fraud Busters Learn From Experience
Nationwide, the federal government estimates it lost $22 billion of its share of Medicaid funding last year to what it calls "improper payments," according to its payment accuracy survey. This suggests that the loss to state treasuries was also in the tens of billions. How do flagrant violations of Medicaid procedure go unnoticed by federal and state regulators for so long?  The answers are not simple. ... As fraudsters' schemes grow bigger and more elaborate, state Medicaid agencies are forced to create equally elaborate schemes to thwart them. But the more paperwork and audits they require from doctors, dentists, pharmacists and other health care providers who serve the needy, the more Medicaid officials worry they will have trouble attracting enough providers willing to accept Medicaid's low fees (Vestal, 6/4).

KQED's State Of Health blog/Center For Health Reporting: Confusion For Parents, Providers Over Sign Up For Dental Managed Care
There's a lot of confusion related to getting on --  and staying on -- Medi-Cal dental managed care in Los Angeles County, where parents have a choice. In Sacramento County, the only other county in the state that offers Medi-Cal dental managed care, the program is mandatory. Several dentists, children’s advocates and parents told me that dental plans play a role in signing patients up for their services (Bazar, 6/1).

Kansas Health Institute News: Governor Signs Budget Bill, Sine Die
Gov. Sam Brownback has signed the budget bill into law but vetoed about a dozen line items, including a temporary bump in the rates paid to payroll agents for home- and community-based services. … In the budget bill it approved, the Legislature had signed off on a temporary increase in the rates paid to payroll agents for those who receive home- and community-based services through the state's Medicaid program. The rate boost would have taken the $115 per client per month currently paid to the agents to $125. Supporters of the increase said it would help the payroll agents transition to a new system launched late last year by the Kansas Department on Aging and the Kansas Department of Social and Rehabilitation Services (Shields, 6/1).

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