Clip files / Local news from the states
Clip files / Local news from the states
This column features selected short items about state health care policy.
Louisiana scrambles to settle Medicaid issues
BATON ROUGEWith time running out on the Bush administration, Gov. Bobby Jindal and state officials are working with Washington policy-makers on a range of issues that could affect how health care is delivered in Louisiana. The state's recent discussions with the U.S. Department of Health and Human Services have centered on three issues:
- A partial transformation of the state Medicaid program into an HMO-style system in which patients would have a choice of managed care plans and access to local clinics.
- The federal government's reimbursement to the state for the damage to Charity Hospital from Hurricane Katrina.
- A final settlement on $600 million that the federal government claims Louisiana owes for past overspending in its Medicaid program.
The negotiations began shortly after Gov. Jindal took office in January and have taken on a new urgency since the close of the legislative session in June, with U.S. Health and Human Services Secretary Michael Leavitt visiting Baton Rouge this week for a private meeting with Gov. Jindal, state Health and Hospitals secretary Alan Levine and the presidents of Louisiana State and Tulane universities.
The talks come about 18 months after the state rejected a plan, backed by Mr. Leavitt, to restructure the state's charity care safety net by using some of the money that now flows to the LSU-run hospital system to buy private health insurance for some low-income uninsured residents.
Mr. Levine said the overhaul plan that's now being negotiated would not disrupt the flow of "disproportionate share" money that pays for uninsured care in the LSU-run Charity Hospital System, but would instead seek to rely on state and federal dollars that already go into Medicaid.
"Our goal is to make sure every Medicaid recipient has the ability to choose from among a network of providers that are adequate to their needs," Mr. Levine said. "We have a $7 billion program [now], and all we do is pay claims."
The Times Picayune 7/26/2008
Medicaid report disputed in Ohio
COLUMBUSThe state's Medicaid director is questioning the accuracy of a report critical of a Gov. Ted Strickland's proposal to require preauthorization for costly drugs used to treat mental health patients. John R. Corlett, who heads the Medicaid program housed in the Ohio Department of Job and Family Services, responded recently in a letter to the National Alliance on Mental Illness (NAMI) Ohio in which he called the report "erroneous" and questioned the "factual and cost conclusions."
He was responding to a study done by Howard Fleeter, a Columbus economics consultant and former Ohio State University professor, which was released earlier this week by NAMI Ohio. Mr. Fleeter's report concluded that the administration's plan to require prior approval of a handful of costly drugs used to treat bipolar disorder, schizophrenia and other serious mental health conditions might actually cost the state up to $38.7 million and could trigger higher medical and hospitalization costs, lost wages, homelessness and even incarceration of mentally ill patients.
Not so, Mr. Corlett said. He said current patients who receive medications under Medicaid would be "grandfathered" in and would not have to switch drugs or obtain prior approval. It would, however, apply to new patients. Even at that, Mr. Corlett said, many psychiatrists and others who now prescribe mental health drugs will continue to be able to do so without prior approval. The restrictions will apply to only those prescribers who do not specialize in psychiatry, such as general practice physicians. The study said the policy could affect up to 45,000 people.
Mr. Corlett also objected to the report's conclusions about the lack of savings. He said the original $47 million estimate was avoided costs, not just savings. A final estimate will be done when the proposed rule change is submitted in the coming weeks to the Joint Committee on Agency Rule Review, Mr. Corlett said.
Columbus Dispatch 7/11/2008
This column features selected short items about state health care policy.Subscribe Now for Access
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