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Financing Center of Excellence

Welcome to the newly enhanced SAMHSA Financing Center of Excellence (COE) website which features the latest news, reports, and information on financing health care and mental health/substance use services. To browse the site, choose from the Categories and Topics or use the Search Advanced Search.

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SAMHSA's Weekly Financing News Pulse: State and Local Edition- August 31, 2011


Topics: Financing News Pulse- State and Local Edition

Download the Pulse hereWeeklyFinancingNewsPulseStateandLocalEditionfinal20110831.pdf (PDF | 188.76 kb)

In this edition:

  • Court Finds Arizona’s Mandatory Medicaid Copayments Illegal
  • Arkansas Governor Announces Medicaid Care Coordination Initiative
  • California Medical Association Files FOIA Request to Assess State’s Analysis of Medicaid Cuts
  • CMS Finds 50 Percent of Colorado’s Medicaid Eligibility Determinations Did Not Meet Federal Requirements
  • Georgia DCH to Request $520 Million to Address Medicaid and CHIP Deficit
  • Kansas SRS to Implement $19.3 Million in Medicaid Cuts
  • Kansas’ Medicaid Program Implements Electronic Prior Authorization Program to Save $1.5 Million:
  • Update: Aetna Continues Challenging Louisiana DHH’s Selection Process for Coordinated Care Network Participants
  • New York Recovers $2.3 Million in Medicaid Overpayments
  • Psychiatric Hospital to Open by October in Dayton, Ohio
  • TPS Working to Authorize $1.3 Million in Privately Provided School Mental Health Services in Tulsa, Oklahoma
  • Update: Oregon Implementing Medicaid Reform Legislation
  • Report Estimates National Health Reform will Reduce Uninsurance, Increase Premiums in Wisconsin

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Financing News Pulse/ FCOE Website Updates



Over the next few weeks, SAMHSA’s Financing News Pulse and the FCOE Website Updates 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.

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Declines in Physician Acceptance of Medicare and Private Coverage

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Topics: Individual Coverage | Medicare | Rates/Reimbursement

A study published in the Archives of Internal Medicine found that 88 percent of physicians accepted new privately insured patients in 2008, down from 93 percent in 2005.  The authors cited low reimbursement rates and significant administrative burdens as possible reasons for the decline.  The study also notes that rate of acceptance declined less for Medicare beneficiaries, dropping from 96 to 93 percent between 2005 and 2008.

Bishop, Tara F. et. al. (2011). Declines in physician acceptance of Medicare and private Coverage. Archives of Internal Medicine, 171 (12): 1117 - 1119. doi:10.1001/archinternmed.2011.251. http://archinte.ama-assn.org/cgi/content/short/171/12/1117

Authors: Tara F. Bishop, Alex D. Federman and Salomeh Keyhani.

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For the Public’s Health Revitalizing Law and Policy to Meet New Challenges

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Topics: Legislation (National) | Legislation (State & Local)

On June 21, the Institute of Medicine (IOM) released a report, suggesting that federal and state governments review and revise public health laws to ensure that they adequately address the current health care landscape.  Created at the request of the Robert Wood Johnson Foundation (RWJF) and presenting the findings of a committee of experts, the report also stresses the importance of evaluating the effects of non-health care legislation, noting that such legislation can have a significant impact on public health.  Finally, the report recommends that states require health agencies to require 10 essential public health services.

From the report:

Good health is not merely the result of good medical care but the result of what we do as a society to create the conditions in which people can be healthy. Public policy can be one of the most effective approaches to protecting and improving the health of the population. Unlike the one-on-one care provided by clinicians, laws, regulations, and other policies can affect the health of millions. This makes "healthy" public policy particularly important in a time of scarce resources, because it can diminish or preclude the need for other, more costly and potentially less efficient interventions.

Full report: For the Public’s Health Revitalizing Law and Policy to Meet New Challenges (PDF | 433 KB) exit disclaimer small icon

Institute of Medicine. For the public’s health revitalizing law and policy to meet new challenges.

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Jobs at Risk: Federal Medicaid Cuts Would Harm State Economies

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Topics: Health Care Reform | Legislation (National) | Medicaid | State Data

On June 29, Families USA released a report examining Medicaid cuts outlined under U.S. Rep. Paul Ryan’s (R-WI) $3.5 trillion FY2012 budget proposal, approved by the U.S. House on April 15.  In addition to repealing most provisions of the national health care reform law, the budget would also convert Medicaid into a block grant program beginning in 2013, reducing state payments by 5 percent in 2013, 15 percent in 2014, and 33 percent in 2021.  Based on an economic modeling tool used by the U.S. Department of Commerce to assess the impact of major events on regional economies, Families USA’s analysis finds that the Medicaid cuts would risk a total of 35,210 jobs and $4.2 billion in economic activity.  The report estimates that the cuts would harm program enrollees, reduce business activity, and contribute to job losses.  The report also provides state-level estimates of the impact of each cut on business activity and jobs.

From the report:

The Medicaid program is a unique federal-state partnership. It gives states great flexibility to design their programs and control their spending. Every state Medicaid program must cover certain very low-income children, pregnant women, and some seniors and people with disabilities, and it must provide them with, at minimum, a defined set of basic health benefits. However, aside from these minimal requirements, states have broad authority to expand Medicaid to more people and/or cover more services. Each state’s policy makers must determine who will be covered, what kinds of health care services will be covered, how much the state will spend overall, and where Medicaid fits among competing demands for limited state dollars.

Full report: Jobs at Risk: Federal Medicaid Cuts Would Harm State Economies (PDF | 335 KB) exit disclaimer small icon

Families USA. (2011). Jobs at risk: federal Medicaid cuts would harm state economies.

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The Fiscal Survey of States


Topics: Medicaid | Spending | State Data

The National Governors Association (NGA) and the National Association of State Budget Officers (NABO) released the Spring 2011 Fiscal Survey of States, finding that at least 33 states have plans to reduce Medicaid provider reimbursement rates for the fiscal year beginning July 1.  Facing tough financial climates and the elimination the increased Federal Medical Assistance Percentage (FMAP) funding through the American Recovery and Reinvestment Act (ARRA), on average, governor’s proposed FY2012 budgets include a 2.9 percent reduction in Medicaid funding.  However, states’ share of Medicaid is expected to increase by 18.6 percent as federal funding drops by 13 percent.  In FY2010, Medicaid accounted for an estimated 22 percent of states’ spending.

From the report:

Fiscal 2011 represented the beginning of a turning point in state fiscal conditions following two of the most difficult years for state finances since the Great Depression. While general fund spending has risen during fiscal 2011 and governors forecast spending to rise again in fiscal 2012, the combination of a loss of Recovery Act funds and a national economy that is recovering slowly are likely to result in the continuation of challenging fiscal conditions for fiscal 2012 and beyond.

Full report: The Fiscal Survey of States (PDF | 2.54 MB) exit disclaimer small icon

National Governors Association. (2011). The fiscal survey of states.

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