Ohio changes Medicaid drug program, N.C. weighs cuts in Medicaid personal care services

Feb 3 2010

The Cleveland Plain Dealer reports that Ohio's seven Medicaid managed care plans this month will make changes in the prescription drug plans that cover about 1.5 million people, although many of those beneficiaries will not face increased costs.

The changes are expected to save the state about $243 million. "Members who are exempt, such as children under the age of 21, pregnant women, people who are in the hospital, those in a long-term care facilities such as nursing homes as well as consumers receiving hospice and family planning services will not have to pay [for prescriptions]. But about 400,000 residents statewide will now have a co-pay for certain medications. It's $3 for drugs that require prior authorization from Ohio Medicaid and $2 for trade-name drugs. There's no cost for generics" (Tribble, 2/1).

The Associated Press/Business Week reports on Medicaid in North Carolina. "State Medicaid leaders are in a fiscal bind. North Carolina's share of the $10 billion federal-state health care program for poor families, senior citizens and the disabled -- is on track to spend $250 million more than budgeted this year despite the Legislature's demands to cut more than $500 million from the Medicaid agency. The shortfall will only worsen unless they scrutinize more vigorously the amount of personal care services received by more than 37,000 people. ... The state already has spent 4 percent more than the $188 million annual budget for personal care service in just the first six months of the fiscal year, even after regulators cut payment rates to companies that provide the services" (Robertson, 2/1).

Deseret News reports on budget issues in Utah. "Base budget cuts of $23.5 million, or about 5 percent, in state public health and human services programs received subcommittee approval Monday, despite an afternoon of testimony from managers that thousands of homebound seniors and low-income Utahns will be hurt. County and regional health departments are maxed out both by increasing need and the use of volunteers to supplement programs for the needy, including Meals on Wheels services to the aged, members of the Health and Human Services Appropriations Subcommittee were told" (Thalman, 2/1). 

Chattanooga Times Free Press reports that north Georgia "hospitals are 'tremendously opposed' to a proposed tax on hospitals' net patient revenues, a fee that state officials say is the most palatable method to sustain the state's struggling Medicaid program. ... During a recent state budget hearing in Atlanta, state officials said Georgia's Medicaid program has a deficit of about $500 million. The proposed 1.6 percent tax on hospitals and Medicaid managed-care companies could raise $345 million in state funds -- $247 million from hospitals alone. The money would be funneled back into Medicaid and draw down almost $1 billion in federal matching funds, forestalling a potentially devastating reimbursement rate cut. ... Still, government officials said the only alternative to the tax is a 16.5 percent across-the-board cut to Medicaid reimbursement rates for all providers" (Bregel, 2/2).

The Florida Times-Union: "Managed-care organizations pressed Monday for lawmakers to move forward with a planned statewide expansion of the Medicaid reform program, while advocates for patients urged caution. Representatives for health plans pushed for the state to require Medicaid recipients statewide to join managed-care plans, much as patients in Duval, Baker, Clay, Nassau and Broward counties must do now. ... Key to the plan is a drive to stem the growth of Medicaid costs, which are expected to consume larger portions of the state budget in coming years" (Larrabee, 2/2).

Meanwhile, "[t]he recession is forcing states such as Washington to pare back health insurance programs for low-income people, even as growing joblessness boosts demand for help," according to Kaiser Health News, in collaboration with USA Today. "Five of six states that use state funds to assist adults not covered by Medicaid are considering cuts, barring new enrollment or raising fees. The more than 250,000 people in the state programs are adults who don't qualify for the joint federal-state Medicaid program, either because they don't have children or earn more than the tight limits states impose on Medicaid eligibility. They represent a tiny fraction of people who get government health insurance, yet the state programs are often their sole option for coverage." Programs in Washington, Tennessee, Connecticut, Pennsylvania and Minnesota are struggling (Appleby, 2/2).