Clip files / Local news from the states

This column features selected short items about state health care policy.

Judge OKs Medicaid settlement plan

AUSTIN, TX—The 2.8 million-plus needy children in Texas' Medicaid program should have better access to checkups, timely prescriptions and other services under a court settlement approved by U.S. District Judge William Wayne Justice. That's the hope and prediction of children's advocates and state officials who backed the settlement proposal. "The court concludes the proposed corrective action plan is fair, reasonable and adequate," said Justice. He's expected to sign a formal order later. Lawmakers budgeted a boost of nearly $1.8 billion over two years—$706.7 million in state general revenue and the rest in federal matching funds—for improvements including higher rates for doctors and dentists who treat youngsters under the Medicaid program. The rate hike is meant to increase the number of health care providers who treat children under Medicaid.

About one-third of dentists, and about 62% of doctors, serve Medicaid patients, said Health and Human Services Executive Commissioner Albert Hawkins. Although the number of doctors participating overall is higher than the number of dentists, the Texas Medical Association found only 38% of physicians accept all new Medicaid patients who seek care; another 26% limit the Medicaid patients they'll take; and 36% accept none. The legislature approved enough money for a 25% rate increase for doctors and 50% for dentists. But those working on the plan intend to target the funds at key services instead of giving a flat, across-the-board increase. That would mean bigger hikes for basic dental services such as X-rays and fillings and key physician services such as checkups and immunizations. The plan also addresses services including outreach; case management; timely answering of toll-free hotlines; ensuring needed prescriptions aren't held up just because the medicine isn't on the state's preferred drug list; and provision of transportation.

— Houston Chronicle, 7/10/07

Delaware program targets uninsured children

DOVER—Delaware Insurance Commissioner Matt Denn is launching an effort to sign up an additional 1,000 children for the state's Healthy Children Program. About 5,000 of the estimated 10,000 to 12,000 children eligible for the program are currently enrolled. The program covers children 19 and younger whose parents earn too much to qualify for Medicaid but can't afford private insurance. Premiums range from $10 to $15 a month. Mr. Denn said he's set his target at 1,000 because that equals the amount of children who could be covered using federal money that goes unspent by the state and is sent back to Washington. If the program succeeds, Denn said it would cost the state about $500,000 to meet its 40% share of the program's cost. "The situation now is unacceptable," Mr. Denn said. "About half the children who could be getting coverage though Medicaid or the Delaware Healthy Children Program aren't signed up…. If we reach our goal, enrollment will increase by 20% but, whether we sign up an additional 50, 500, or 1,000 children, we will be improving their quality of life." Mr. Denn said his department will work with the state education department to seek children who take part in the free and reduced-price lunch programs, and through labor unions, churches, and community groups. The program will use volunteers who will go into churches, community centers, and neighborhoods to sign up families. He estimates the outreach program could cost up to $160,000.

Wilmington News Journal, 7/16/07