Kaiser Daily Health Policy Report Highlights Medicaid News In Three States

Main Category: Medicare / Medicaid / SCHIP
Article Date: 24 Dec 2008 - 3:00 PDT

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Summaries of recent news involving Medicaid in Louisiana, Rhode Island and Texas appear below.

• Louisiana: Louisiana's Joint Legislative Committee on the Budget on Friday approved Gov. Bobby Jindal's (R) plan to seek a federal Medicaid waiver that would allow the state to overhaul the health coverage program, the New Orleans Times-Picayune reports. The proposal will now be sent to CMS (Barrow, New Orleans Times-Picayune, 12/20). The Louisiana Joint Health and Welfare Committee unanimously approved the plan on Thursday. Under the "Louisiana Health First Plan," managed care pilot programs would be established in New Orleans, Baton Rouge, Lake Charles and Shreveport. Medicaid beneficiaries would work with state-approved counselors to choose between two or more private health plans. Insurers would be paid a flat monthly fee per beneficiary, which would vary depending on the beneficiary's health. Plans then would negotiate fees with doctors, hospitals and other providers in the network and collaborate to provide coordinated care. Eventually the plan would expand coverage to 106,000 uninsured state residents. The plan would be funded by asking the federal government to excuse debt owed by the state for past overspending and by redirecting money that now goes to LSU Charity Hospital System for treating uninsured patients. The plan also would generate savings through better coordinated care (Kaiser Daily Health Policy Report, 12/19).
  
  
• Rhode Island: Rhode Island Gov. Don Carcieri (R) and the Bush administration on Friday reached an agreement that would set a $12 billion, five-year spending cap on the state's Medicaid program in exchange for greater Medicaid spending flexibility, the AP/Arizona Daily Star reports. Under the agreement, Rhode Island would be responsible for any spending that exceeds $12 billion during that period. HHS Secretary Mike Leavitt said, "This demonstration will allow Rhode Island increased flexibility to adjust its Medicaid program to better serve the health care needs of the state's beneficiaries." Congressional Democrats and many health care experts have expressed concern about the possibility that medical services could be cut if the state cannot control spending. According to the AP/Star, the deal "could dramatically restrict the state's nursing home services for the elderly and adjust health care and prescription drug coverage" for low-income residents and people with disabilities. Lawmakers in the state Assembly have 30 days to reject the agreement (AP/Arizona Daily Star, 12/20).
  
  
• Texas: The state will automatically extend for 90 days Medicaid coverage for about 34,000 children living in areas affected by Hurricane Ike because the storm might have made it difficult to re-enroll, the Dallas Morning News reports (Garrett, Dallas Morning News, 12/22). Stephanie Goodman, a spokesperson for the Texas Health and Human Services Commission, said more than half of the 72,000 children across the state who did not re-enroll in the program lived in Houston and Beaumont, which were both hit by the hurricane. Goodman said, "We expect to see some swings in enrollment, but this was bigger than normal," adding, "Seeing a high percentage from one area also raised warning signs that we need to stop and take a look at this." Officials are looking into whether displacements and other interruptions caused by the hurricane might have prevented families from completing the paperwork (Elliott, Houston Chronicle, 12/18). Goodman said the state will send out new re-enrollment packets and encourage parents to complete them by April 2009 (Dallas Morning News, 12/22). State HHS Commissioner Albert Hawkins on Monday said, "Given the widespread damage and disruption in services caused by Ike, we believe it is wise to err on the side of caution and give these families more time to renew their children's coverage." The extension begins on Jan. 1, 2009 (MacLaggan, Austin American-Statesman, 12/23).

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