Rhode Island Gov. Carcieri Releases Global Medicaid Waiver Application

Main Category: Medicare / Medicaid / SCHIP
Article Date: 01 Aug 2008 - 11:00 PST

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The administration of Rhode Island Gov. Don Carcieri (R) on Tuesday released an application for a "global Medicaid waiver" that would allow the state to make broad changes to the program in exchange for capping spending, the Providence Journal reports.

In adopting a global waiver, the governor would agree to limit Medicaid spending to $12.4 billion through 2013. State Department of Human Services Associate Director Murray Blitzer said that if the state runs out of its allotted funds before the five-year mark it will lose matching federal funds, which would force the state to pay the program's full cost or cut services. In exchange for capping spending, the state would receive broad authority to change services, such as nursing home care, subsidized transportation for the elderly and beneficiaries with disabilities, health insurance for low-income children and parents, and prescription drug coverage for seniors, according to the Journal.

If approved, the waiver is expected to save the state an estimated $67 million this year. The Carcieri administration released the waiver application to the General Assembly 10 days before it will be submitted to federal regulators.

Adelita Orefice, state deputy secretary of the Office of Health & Human Services, said the proposal intentionally left out details about how people would be affected by the waiver. She said, "You're going to see some of the larger concepts in here about the direction and the values and that sort of thing, but not a whole lot of detail about programs specifically, in part because we want to be able to preserve that flexibility," adding, "If we propose right now the details ... then we're going to be wedded to that. And if in a year that doesn't work, and that kind of program makes no sense, we're stuck" (Peoples, Providence Journal, 7/30).

Additional information from the state is available online.

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