States Revise Medicaid Programs
Kentucky and West Virginia are the first two states to revise their Medicaid programs under a new federal law that allows increased flexibility, the AP/San Diego Union-Tribune reports.
Kentucky plans to establish separate Medicaid coverage plans with different benefits for the general population, children, the elderly and the developmentally disabled. In addition, the state plans to limit Medicaid prescription drug coverage and limit physical therapy and speech therapy visits to 15 annually per beneficiary.
The revisions will save Kentucky an estimated $200 million over two years, state Medicaid Commissioner Shannon Turner said. She added, "We made the decision early on that our goal would be to provide reasonable health benefits for the current population of eligibles rather than unlimited benefits for a smaller population."
Meanwhile, West Virginia plans to allow 160,000 Medicaid beneficiaries -- many of whom are parents of children enrolled in the program -- to sign a "personal responsibility contract," under which they agree not to miss physician appointments and visit the emergency department only for emergencies. Medicaid beneficiaries who adhere to the contract every three months will receive credits that they can use to purchase additional benefits. The state will place Medicaid beneficiaries who fail to adhere to or decline to sign the contract in a basic coverage plan with limited benefits.
Shannon Riley, a spokesperson for the West Virginia Medicaid program, said, "We don't expect any immediate cost containment. What we hope to see is that these healthy children whose parents are responsible and sign the member agreement ... dramatically improve the long-term health care outcomes of these children."
HHS spokesperson Christina Pearson said other states have considered revisions to their Medicaid programs under the new law, with plans from an unidentified third state scheduled for approval this week.
Dennis Smith, director of the Center for Medicaid and State Operations at CMS, said, "We have several states that we're already having discussions with. And you can believe the phone lines have been lit up to Kentucky and West Virginia in the past week."
Judith Solomon, a senior fellow at the Center on Budget and Policy Priorities, said that increased flexibility for state Medicaid program likely will lead "to people not getting things they need" (Freking, AP/San Diego Union Tribune, 5/23).