Clip files / Local news from the states

Audit assails state Medicaid oversight

SEATTLE—The state fails to verify adequately the eligibility of some of its Medicaid clients, as well as the license records of almost one-fourth of the health professionals the government pays to care for them, according to a draft state audit obtained by the Seattle Post-Intelligencer. Those two conclusions — based on samplings of the state’s $4 billion-a-year Medicaid program — are the most substantial findings in the state auditor’s broad annual review of Washington’s use of federal funds, which is expected to be released in about a week, state auditor Brian Sonntag said. The report, required by the federal government, contends that the state is not complying with Medicaid requirements of the federal government, which pays for half of Washington’s Medicaid program. It’s up to federal officials to decide whether any noncompliance jeopardizes funding, Sonntag said. "This is a very substantial amount of public funds. It’s a very significant report, and it’s one that the state has to respond to," he said. "If this doesn’t get cleaned up, then I think it puts the future of these kinds of federal funds at potential risk."

Officials at the state Department of Social and Health Services (DSHS), which runs Medicaid, acknowledged concern over the findings. But DSHS argues that the Auditor’s Office overstated the seriousness of the problem. Many of the findings can be explained, the agency said, and steps are being taken to improve the monitoring of client eligibility and provider licensure.

Seattle Post-Intelligencer, March 13

State could get help with Medicaid shortfall

WASHINGTON, DC—West Virginia could receive $114 million from the federal government over the next three years to plug financial holes in Medicaid, even as the state program for the poor and disabled faces a $187 million deficit next year alone. Sen. Jay Rockefeller (D-WV) has proposed legislation to reimburse states for losses caused by a business tax break recently approved by Congress. The tax incentive, which allows businesses to write off part of the cost of capital investment, could cost West Virginia’s bottom line between $70 million and $86 million over the next three years. At the same time, most states, including West Virginia, are facing shortfalls in their Medicaid programs.

Rising unemployment, growing enrollment, and increases in health care costs have put strains on the program. While West Virginia should be able to cover its Medicaid costs this year, Commissioner Nancy Atkins says the program faces a $187.3 million shortfall in the new fiscal year, beginning July 1. Since last July 1, enrollment in the program has climbed sharply, adding 14,730 new participants, most of them children. "We continue to go up every month," she said. Ms. Atkins and other administration officials have been discussing solutions to Medicaid’s looming fiscal problem. None of them are pretty: cutting services, tightening eligibility requirements, or slashing reimbursements to health care providers. The Rockefeller proposal would give every state a 1.5 percentage point increase in reimbursement rates through September 2004. States with high unemployment, including West Virginia, also would be eligible for an additional rate increase for the same three year period.

Charleston Daily Mail, March 20

State taps Medicaid for Internet service

CHICAGO—Illinois Public Aid officials are paying a Massachusetts company $2,000 for each Medicaid family signed up to an Internet service designed to monitor the condition of sick children and to educate parents, even though three-quarters of the families don’t own a computer. The no-bid deal makes Illinois the first state to dip into overburdened Medicaid funds to pay for the fledgling Baby CareLink program, which was touted here by a key Republican Party official and lobbyist.

Illinois Public Aid officials have earmarked $400,000 for Baby CareLink at Cook County Hospital and Mount Sinai Medical Center, Chicago hospitals that record the state’s highest number of Medicaid births. If the pilot program is expanded statewide, Clinician Support Technology of Framingham, MA, a for-profit company, could earn as much as $12 million a year.

Baby CareLink is aimed at parents of premature infants who need weeks of hospitalization in intensive care. Parents can access information about their child’s condition and read dozens of educational articles on how to provide better care at home. They also can view photos of their child.

"We hook these parents when their baby is at death’s door — the moment of truth, maternal instinct," said Dennis Farrell, executive vice president of the company. "We get them using Baby CareLink, and it answers their informational and emotional questions." He acknowledged that most parents don’t have home access to the Internet but said parents without computers can use those at the hospital installed by his company or computers owned by friends or relatives.

With the state slashing basic Medicaid services for doctors and nursing homes, not every state official is embracing the CareLink program. "If the goal is to provide lower-income parents with greater access to their infant children in hospitals, then it would be far less expensive to pay for cab fare every day than to throw this money into a relative luxury, such as viewing your children over the Internet," said state Rep. Jeff Schoenberg (D-Evanston), chairman of a House appropriations committee.

Chicago Tribune, March 24