Highlights: N.Y.'s $8B Medicaid waiver; Conn. Medicaid application delays settlement; managed care overpayment in Washington state

Apr 16 2014

A selection of health policy stories from New York, Connecticut, Washington state, Kansas, Florida, West Virginia and California.

The Associated Press: N.Y. Gets Final Terms For $8B Medicaid Waiver
New York and federal officials report final agreement allowing the state to reinvest $8 billion in Medicaid savings to support hospital overhauls and expand primary medical care over the next five years. The goal of the Medicaid waiver is to reduce avoidable hospital use by 25 percent while helping financially struggling hospitals shift to more primary and outpatient care (4/14).

The CT Mirror: Proposed Settlement Reached In DSS Medicaid Application Delay Lawsuit
The Department of Social Services is seeking approval to hire dozens of additional workers to comply with a proposed settlement to a class action lawsuit alleging that delays in processing Medicaid applications have left poor state residents waiting months to get coverage and care. Meeting the settlement's terms would require hiring 35 additional workers at a cost of more than $2.5 million per year, Social Services Commissioner Roderick L. Bremby wrote in a recent letter to Attorney General George Jepsen. Those positions would be in addition to 103 new positions for the department included in Gov. Dannel P. Malloy's proposed budget for the coming fiscal year (Becker, 4/15).

The Seattle Times:  State Medicaid Audit Suggests $17.5 Million Overpaid 
The state's Health Care Authority did not have enough oversight and control over its Medicaid managed-care program in 2010, according to a state audit of the program, which may have racked up an estimated $17.5 million in overpayments by contracted managed-care organizations to doctors, hospitals and other care providers. Overpayments are important, because total payments reported by the managed-care organizations are used to calculate future premiums paid by the state to the organizations, notes the report, which was released Monday (Ostrom, 4/14).

Kansas Health Institute:  Managed Care Program For Elderly To Expand In Kansas
It's been about three and a half years since Linda Cranmer's left leg was amputated a few inches below the knee. At the time, Cranmer, then 62, was living in Scranton, a small town about 20 miles south of Topeka. Eighteen months later, Cranmer was able to get into the Programs for All-inclusive Care For the Elderly program, and things began to look up for her. The Medicare- and Medicaid-funded managed care program for people who are 55 or older, low-income and close to being admitted to a nursing home has been a relatively small player in Kansas' efforts to help frail seniors such as Cranmer avoid expensive nursing home care but is poised to take on a much larger role. But Kansas now has plans to expand the program (Ranney, 4/14).

Miami Herald:  Florida Lawmakers Will Re-Evaluate Funding Model For Safety Net Hospitals 
With the federal government making clear last week that no new Medicaid money is coming Florida's way, legislators say it's important they re-evaluate a new funding model that safety-net hospitals say will cost them hundreds of millions of dollars a year. "Tiering" is set to take effect in July unless the law is changed before session ends May 2. It requires counties that use local dollars to draw down more federal money for hospitals to begin sharing that money statewide (Mitchell, 4/14).

The Miami Herald:  Florida Lawmakers Consider Health Care Law Change Aimed At Jackson
A high-profile health care bill moving through the Florida House could strip the Miami-Dade County Commission of its authority to make the final decision on labor union contracts at the county's public hospital system. The bill originally sought to create new rules for trauma centers, allow skilled nurses to practice independent of physicians, and pave the way for hospitals to use virtual healthcare services (McGrory, 4/14).

The Associated Press:  Plan Would Change How State Of Florida Pays For Mental Health Care 
The Florida Legislature is considering a plan that would change the way the state pays to treat people who need emergency mental health care, a move critics say would gut the current system to benefit large hospital systems. Under the current system, the state Department of Children and Families contracts with 117 public and private Crisis Stabilization Units around the state to provide emergency mental health treatment, paying nearly $300 a day per bed regardless of whether they are occupied. The system, which cost the state $61.3 million last year, guarantees that the crisis units have enough beds and staff to meet peak needs, supporters say (Miller, 4/14).

The Associated Press:  W.VA. Home, Long-term Care Costs Rise
An annual survey shows long-term and home health care costs in West Virginians are outpacing such costs nationally. The Cost of Care Survey released Monday by Genworth Financial shows the median hourly cost of home health aide services in West Virginia has increased 3.8 percent annually over the past five years. Nationally, the annual increase was 1.3 percent. West Virginia's median hourly rate for homemaker services increased 3.6 percent annually during the same period. Nationally, the annual increase was about 1 percent (4/14).

The California Health Report: Mental Health Courts Give Mentally Ill Offenders The Option Of Treatment
Cholena Loewenthal remembers a great childhood: success in school, lots of friends, a supportive family. But she knew something wasn't quite right with her. She was unable to complete tasks and had difficultly focusing. Shopping was a compulsion for her. She had to buy things regardless of her financial ability. At age 18, she read a pamphlet about bipolar disease and knew she had the illness. But she didn't get a medical diagnosis until she was 28 (Graebner, 4/15). 

The California Health Report: Strange Bedfellows Unite To Help Older Adults
In the near future, successful care for older adults will depend on bold and creative collaborations. That's the message aging pioneer Ken Dychtwald gave last month's Aging in America conference. Dychtwald, CEO of the consulting group Age Wave, might as well have been describing the "strange bedfellows" collaboration between two organizations often considered mortal enemies -- a county aging services agency and a managed health care plan. In San Diego County, Aging and Independence Services (AIS) has long been heralded as one of the nation's most progressive organizations serving older adults. It acts as the local Area Agency on Aging, or AAA -- one of 59 statewide (Perry, 4/14).