N.J. plans to use managed care system for Medicaid enrollees with mental health problems

Nov 15 2011

The N.J. effort must secure federal approval first. Also in Medicaid news, a judge in California this week will hear arguments in the challenge to the state's plans for adult health care.

NJ Spotlight: Medicaid Seeks To Bring Managed Care To Behavioral Services
New Jersey is seeking federal approval to redesign its system for providing behavioral health services to Medicaid members -- one of the many changes the state Department of Health (DHS) proposed in the Comprehensive Medicaid Waiver it submitted in September. If the plan is approved, it would mark the first time that adult Medicaid beneficiaries with mental illnesses and addictions would be administered by a behavioral health managed care provider. The DHS has long used managed care to deliver physical health services to most of the Medicaid population (Fitzgerald, 11/14).

California Healthline:  Judge About To Rule On ADHC Issues
Tomorrow, a federal judge is scheduled to hear the long-delayed court case challenging the state's adult day health care transition plan. Both sides are trying to hash out a compromise settlement.  ... The state is due to eliminate ADHC as a Medi-Cal benefit on Dec. 1. The lawsuit challenges the efficacy of the transition plan proposed by DHCS to provide necessary care for 35,000 ADHC beneficiaries (Gorn, 11/14).

And in other state Medicaid news:

Los Angeles Times: Red Tape Hampers Care For Patients Who Are Poor And Disabled
These patients -; 1.1 million in California alone -; are some of the country's priciest government healthcare consumers. Called dual eligibles, they accounted for close to 40 percent of Medicaid spending in California in 2009, nearly $10 billion, but constitute only about 15 percent of enrollees. Nationwide, the nearly nine million dual eligibles have similarly disproportionate outlays (Gorman, 11/13).

Billings (Mont.) Gazette: Survey: Parents Are Highly Satisfied With Medicaid And CHIP
A recent survey of nearly 2,000 parents suggests a federal health insurance program designed to help those who require financial aid is working. Parents of children using Medicaid or the Children's Health Insurance Program (CHIP) show high satisfaction with their access to doctors and the quality of health care they receive, according to a survey conducted by the Centers for Medicare and Medicaid Services(Uken, 11/12).

Milwaukee Journal Sentinel: Medicaid Changes To Hit Community Centers First
Community health centers, which provided care to 271,000 patients statewide and almost 78,000 in Milwaukee last year, would be among the first to see the effects of the proposed changes to BadgerCare Plus and other state health programs (in Wisconsin). The changes -- approved Thursday by the legislative committee that oversees the state budget -- could result in an estimated 65,000 people dropping or losing their coverage, according the Legislative Fiscal Bureau…. And the community health centers, like everyone in the health care system, keep a wary eye on the number of uninsured patients they treat (Boulton, 11/11).