SAMHSA222s Weekly Financing News Pulse: State and Local Edition
August 31
, 201
1 8/31
/
2011
1
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
Arizona Arkansas California Colorado Georgia Kansas
L
ouis
i
ana New York O
hio O
klahoma O
regon Wisconsin
To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care
Financing224: https://service.govdelivery.com/service/multi_subscribe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx
For quest
ions or comments, please contac
t
Rasheda Parks
( Rasheda.Parks@samhsa.hhs.gov ).
Over the next few weeks, SAMHSA222s F
inancing News Pulse will be suspended while SAMHSA reworks its
format and content. Thank you for your continued readership. We look forward to providing you with an
improved product in the near future.
SAMHSA222s Financing News Pulse is a news consolidation service, designed to provide readers with streamlined
access to information published by local, regional, and national media.
While the News Pulse attempts to verify
our content, the editors of each publication cited in the summaries are ultimately responsible for the accuracy of
the information they publish. We encourage readers to inform the News Pulse of any errors so we can note them
in future editions; however, we also suggest that they contact the media source directly.
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
August 31
, 201
1 8/31
/
2011
2
Around the States: State and Local Behavioral Health
Financing News Arizona
Court
Finds Arizona222s Mandatory Medicaid Copayments Illegal
: On August 24, the 9th
U.S. Circuit Court
of Appeals
ruled
that
Arizona222s mandatory Medicaid copayments are illegal. Though
Arizona received a
waiver from the
U.S. Department of Health and Human Services
(HHS) authorizing the copayments
, the
court found
that
the state designed them
only to reduce
Medicaid
spending. Federal law only permits
Medicaid waivers that have
a research or demonstration value. Implemented in 2003 and ranging from
$4 to $30 for medical services and prescription drugs, the copayments
affected approximately 200,000
Medicaid beneficiaries ( The Arizona Republic, 8/25 ; Kaiser Health News, 8/25 ).
Arkansas
Governor
Announce
s Medicaid Care Coordination Initiative
: On August 22,
Governor Mike Beebe
(D)
sent a letter to federal health officials outlining
the components of
a state Medicaid
initiative to improve
care quality and reduce costs through increased care coordination
. Federal officials approved the
initiative in May but had not yet received an outline of program specifics, under which Arkansas will
transition from fee
-
for
-
service financing to an episode
-
based payment
model
. State officials will
implement the new financ
ing model for nine areas of care, including prevention, long226
term care, and
developmental disabilities ( Houston Chronicle, 8/22 ).
California
Cal
ifornia Medical Association Files FOIA Request to Assess State222s Analysis of Medicaid Cuts: The
California Medical Association has filed a Freedom of Information Act (FOIA)
request with the
Centers
for Medicare & Medicaid Services
(CMS) to determine
whethe
r state officials
considered
the effect of
proposed Medicaid cuts
on
health care
access
.
In June, California submitted a request to CMS seeking
approval to cut Medicaid spending by $1.5 billion through a combination of reimbursement rate
reductions, manda
tory copayments, and physician visit
limitations
. Association officials are requesting
that CMS provide documents demonstrating whether the state has considered the impact of the cuts on
access ( Kaiser Health News, 8/30 ).
Colorado
CMS
Finds
50 Percent of
Colorado222s Medicaid Eligibility Determinations Did
Not Meet Federal
Requirements
: On August 23,
Centers for Medicare & Medicaid Services
(CMS) officials presented an
audit
,
finding that Colorado222s Medicaid eligibility determination process does not meet federal
requirements. Conducted from July 1, 2010 to December 7, 2010, the audit found that
approximately
half of the state222s Medicaid eligibility deter
minations
took longer than the maximum allotted time.
Federal law requires states to determine eligibility within 90 days for individuals with disabilities and 45
days for all other individuals. CMS officials say they may withhold federal funding if Colorado
does not
address the deficiency. However, s
tate officials say they have improved the system since the audit and
are continuing to make
improve
ments
( AP via The Denver Post, 8/23 ; Kaiser Health News, 8/24 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
August 31
, 201
1 8/31
/
2011
3
Georgia
DCH
to Request
$520 Million to Address Medicaid and CHIP Deficit
: The Georgia Department of
Community Health
(DCH) is
presenting a request to
Governor Nathan Deal
(R)
seeking
$520 million to
address a Medicaid and
Children222s Health Insurance Program (CHIP)
deficit
. State legislators borrowed
funds from the programs
222
budgets in FY2012 to address shortfalls in other progr
ams. However, without
additional funds, DCH officials say that
the programs face cumulative
deficits of $213
million
and $359
million
for
FY2012 and FY2013, respectively. DCH has sent the request to Governor Deal for preliminary
review but is still accepting public comment before formally approving a budget request in September
( Atlanta Journal-
Constitution, 8/25 ; Kaiser Health News, 8/26 ).
Kansas
SRS
to Implement $19.3 Million in Medicaid
Cuts
: On August 26, the Kansas Department of Social and
Rehabilitation Services
(SRS) outlined
$19.3 million in Medicaid cuts through as
-
yet
-
undetermined
reforms. A
nnounced the cuts as part of
$43 million in
reductions
, the cuts are slated for the current
fiscal year ( Kansas Health Institute, 8/26 ).
Kansas
222 Medicaid Program Implements Electronic Prior Authorization Program to Save $1.5 Million:
On August 23, the
Kansas Medicaid program implemented an electronic prescription drug prior
authorization program. Designed to save time and reduce costs,
the system cost $750,000 and is slated
to save $1.5 million in its first year of operation ( Kansas Health Institute, 8/22 ; Kaiser Health News, 8/23 ).
Louisiana
Update: Aetna
Continues Challeng
ing
DHH222s Selection Process for Coordinated Care Network
Participants
:
Aetna Inc.
is continuing a challenge of the Louisiana Department of Health and Hospitals222
(DHH)
selection process for Medicaid coordinated care network (CCN) program participants. After
DHH
rejected Aetna222s
original complaint
,
Aetna officials have asked Louisiana Commissioner of
Administration Paul Rainwater
to reject all
of
DHH222s
CCN
selecti
ons
. Aetna alleges that DHH officials
did not follow department rules for selecting participating organizations, particularly claiming that the
state compared companies222 proposals rather than analyzing them individually. Authorized under the
FY2012 budge
t, the $2.2 billion program will provide health coverage through private insurers and offer
financial incentives for preventive and primary care. Slated to begin in January, state officials estimate
the program will serve over 800,000 beneficiaries and save $135 million in its first year of operation ( The Times
-
Picayune, 8/23 ; Kaiser Health News, 8/24 ).
New York
New York Recovers $2.3 Million in Medicaid Overpayments
:
New York State Comptroller Thomas
DiNapoli
has announced that state auditors recouped $2.3 million in Medicaid overpayments. State
auditors identified 21 providers charged with abusing Medicaid, Medicare, or other health
programs
that
continued to receive
Medicaid funding. State officials removed
eight of those providers from
Medicaid and are reviewing the remainder ( AP via The Wall Street Journal, 8/23 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
August 31
, 201
1 8/31
/
2011
4
Ohio
Dayton Psychiatric
Hospital to Open by October
: By October, the
former
Twin Valley state mental
health hospital, which closed in 2008
,
will reopen unde
r private ownership as the Access Hospital
Dayton psychiatric hospital. The
$1.7 million physician
-
owned
facility will offer 28 inpatient beds when
it opens, and hospital officials plan to expand to 110 beds within one year ( Dayton Daily News, 8/28 ).
Oklahoma
TPS
Working to Authorize $1.3 Million in Privately Provided School Mental Health Services
: Tulsa
Public Schools officials are working to aut
horize
temporarily suspended
student mental health services.
In June, the district eliminated the $1.3 million that
it
previously
paid six agencies to provide mental
health services at district schools. The agencies independently raised funds to provide the services but
were told that
they cannot provide on-
campus services during regular school hours
because they do not
have a formal contract with the district. TPS officials say they are working with the agencies to establish
formal contracts to allow them to provide services ( Tulsa World, 8/27 ).
Oregon
Update:
State Implementing Medicaid Reform Legislation:
Oregon
officials have begun working
with
mental, physical, and dental health professionals to begin implementation of
the
state222s Medicaid
reform law. Four working groups are
currently developing materials for a February report to the
legislature that will assist in the implementation
. Under the law, the state will
consolidat
e
the 40
managed care organizations that administer coverage into regional Coordinated Care Organizations
(CCO)
that will coordinate physical, mental, and dental care for Medicaid beneficiaries and dual eligibles.
Sta
te officials estimate the law will
save $700 million
in the second year of the
current
biennium ( The Lund Report, 8/24 ).
Wisconsin
Report Estima
tes National Health Reform will Reduce Uninsurance
, Increase Premiums:
Gorman
Actuarial, LLC has released a report projecting that the national health care reform law will reduce the
number of uninsured Wisconsin residents but
will result in higher premiums for health coverage
.
The
authors estimate that the number of uninsured residents will decrease 65 percent by 2016, from
520,000 to 180,000. In contrast, w
ithout the law222s individual insurance mandate, the authors project
the number of uninsured residen
ts
would decline by
only 62,000. However, the report estimates that
the law will increase health coverage premiums, causing
23,000 individuals
to lose coverage because
their employers eliminate their health plans ( AP via Business Week, 8/25 ).
