Health Care Reform News From Around the Nation: October 9, 2007
A dispute between the Kansas Department of Social and Rehabilitation Services and the regional CMS office in Kansas City, Mo., has caused "millions of federal dollars earmarked for Medicaid patient services" to go unpaid, the AP/Wichita Eagle reports.
At issue is $8 million in funding SRS already has received from the federal government.
However, SRS will not distribute the funds to state mental health centers until it is assured by CMS audits that the state will not have to repay overpayments, Ray Dalton, SRS deputy secretary for health care policy, said.
At least six fiscal quarters have gone unpaid, and the delay has resulted in roughly $16 million that will be owed to mental health centers in the state, according to the AP/Eagle.
The delay also has caused at least two community mental health centers to close, lay off workers, consolidate or sell off property.
Dalton said he anticipates that the situation will be resolved within the next few weeks (Hegeman, AP/Wichita Eagle, 10/3).
The Michigan Senate on Thursday approved legislation that would require the state Department of Community Health to develop a program to recoup costs paid by Medicaid for people who lived in nursing homes or received in-home care services before their death, the Detroit News reports.
Gov. Jennifer Granholm (D) was expected to sign the bill.
The state is the last in the nation to pass an estate recovery program required by federal law.
Department of Community Health Director Janet Olszewski, in a letter to state senators earlier this month, wrote that the state could lose $5 billion -- or more than 50% of the state's $8.6 billion Medicaid budget -- in federal Medicaid payments if the state does not comply will the requirement by Sept. 30.
Under the bill, nursing home residents who are current Medicaid beneficiaries would be exempt from estate recovery efforts. Exemptions also include homes occupied by spouses, children who are minors or relatives with disabilities. People also would be able to seek a "hardship exemption," according to the News.
In addition, the measure requires examining options for a voluntary estate preservation program, which could allow residents to make payments to avoid estate recovery (Kozlowski, Detroit News, 9/28).
About 50% of New Jersey's residents said they believe "fundamental changes are needed" for the state's health care system, and about 48% said they would pay $500 annually in additional taxes for universal health coverage, according to a Rutgers University survey released Wednesday, the Bergen Record reports.
The survey of 1,100 residents was conducted over the summer and funded by the Robert Wood Johnson Foundation to assess the public's concerns and support for possible solutions. The poll has margin of error of three percentage-points.
According to the survey, the cost of health care ranked second as the issue residents were "very worried" about, behind incomes not keeping pace with the cost of living.
In addition, the survey found:
- 37% of residents are "very worried" about their ability to afford health coverage;
- 29% of residents are concerned about losing their health coverage;
- One in three residents believes the state needs to "completely rebuild" its health care system;
- 88% of residents said large companies should help their employees with coverage premiums; and
- 83% of residents support expanding programs that provide health coverage to low-income residents, such as Medicaid and NJ Family Care (Layton, Bergen Record, 10/4).
Doctors nationwide are relocating to Texas four years after a constitutional amendment was adopted in the state that limits awards in medical malpractice lawsuits, the New York Times reports (Blumenthal, New York Times, 10/5).
In September 2003, Texas voters passed Proposition 12, a ballot measure that amended the state constitution to allow state lawmakers to pass legislation to cap damages in medical malpractice lawsuits.
Gov. Rick Perry (R) in 2004 signed into law a bill that caps noneconomic damages in malpractice lawsuits at $250,000 for physicians, $250,000 for hospitals and $250,000 for nursing homes and other health care facilities. The legislation also caps total noneconomic damages in malpractice lawsuits at $750,000 per plaintiff. The law does not cap economic damages (California Healthline, 9/28/04).
The state medical board now is backlogged with applications from doctors seeking to practice in the state, with 2,500 applications pending at last count.
However, some experts "say the picture may be more complicated and less positive," the Times reports, questioning "how big a role the cap in malpractice awards has played" (New York Times, 10/5).
Trillium Family Services, the state's largest provider of mental health services for children, on Monday announced that it will cut back on the number of children it serves and will lay off 20% of its staff in response to changes in state policy, the Oregonian reports.
Trillium will provide residential and community-based care to 3,500 children in 2008, compared to 8,600 beneficiaries last year.
According to the Oregonian, in 2005 the state began to shift focus of the children's mental health system to home- and community-based services instead of residential care. The state also changed the way in which it compensated providers, Trillium President Kim Scott said.
The massive reorganization was funded without new dollars," Scott said, adding that the state Department of Human Services is "taking limited resources and trying to spread them across an increasing population of people with increasing problems."
Roughly two-thirds of Trillium's beneficiaries in 2006 were enrolled in Oregon's Medicaid program (Cole, Oregonian, 10/2).
A new South Dakota health insurance risk pool would extend coverage to more than 5,000 uninsured residents, according to a final report released on Monday by the Zaniya Task Force, the Sioux Falls Argus Leader reports.
The task force, established under a recently enacted state law, sought to develop recommendations to ensure that all residents have access to affordable health care.
According to the report, which included 16 major recommendations to the state Legislature, the current state risk pool has not helped those with pre-existing medical conditions who have not recently lost coverage.
The pool was established in 2003 to provide affordable health insurance to residents who lost coverage through no fault of their own.
The report recommended the establishment of a work group to develop eligibility criteria for the new state risk pool, design the program and identify a funding source.
The report also recommended that state lawmakers:
- Establish a work group to encourage state residents who can afford health insurance to obtain coverage;
- Increase efforts to enroll all eligible state residents in Medicaid and the state's version of the State Children's Health Insurance Program;
- Expand SCHIP income eligibility from 200% to 250% of the federal poverty level; and
- Expand eligibility for health insurance premium subsidies funded by Medicaid to allow more low-income state adults to purchase coverage.