New Mexico looks to other states for ideas on Medicaid fix
Published: 2009-10-05 14:35:18
Author: Trip Jennings | New Mexico Independent | September 19, 2009
Come January, New Mexico could face a $300 million shortfall in its low-income health insurance program, and state officials are scrambling to figure out how to address a potential ocean of red ink. The state already has tried many cost-cutting measures—the “low-hanging fruit,” officials call them—to slow the cost growth in Medicaid. But now, because of the severity of the situation, they’re eying many previously off-the-table scenarios.
States across the country are responding to a funding crisis in Medicaid, the government’s low-income health insurance program jointly paid for by the feds and state governments, Laura Tobler of the National Conference of State Legislatures, told New Mexico state lawmakers at an interim legislative committee meeting this week.
Tobler’s message to lawmakers was simple: You are not alone.
California cut provider payments. Florida reduced funding for nursing homes by 10.5 percent. Massachusetts reduced adult dental services for 600,000 recipients of its low-income health insurance program.
Some states are taking several tactics, from fighting against Medicaid fraud to making care for high-risk, high-cost patients more efficient.
New York, a state with a history of Medicaid fraud, recently modified its management information system to better identify improperly paid claims. At the same time that state has created pilot projects with a focus on treating chronically ill Medicaid beneficiaries.
South Carolina, meanwhile, decided to post Medicaid payment information online to try to guard against fraud. It has also reduced—from 34 to 31—the amount of pills in each monthly prescription for Medicaid enrollees.
Utah, which has already cut optional services, created a preferred drug list. Such lists show what prescription drugs are approved for payment. In many cases, the lists limit the drugs to a certain number of drugs in each category of treatment.
The cutting has begun
New Mexico has already begun to make cost-cutting measures, such as starting with capping the amount of money managed care organizations can spend on administrative costs, New Mexico’s Human Services Secretary Pam Hyde said Wednesday.
“The good news is that we’ve already done many of these things,” Hyde said of the cost-cutting steps. “The bad news is that we’ve done many of these things.”
In other words, state officials are now looking for more ways to trim spending, including eliminating many, if not all, optional Medicaid services.
Full story
Published: 2009-10-05 14:35:18
Author: Trip Jennings | New Mexico Independent | September 19, 2009
Come January, New Mexico could face a $300 million shortfall in its low-income health insurance program, and state officials are scrambling to figure out how to address a potential ocean of red ink. The state already has tried many cost-cutting measures—the “low-hanging fruit,” officials call them—to slow the cost growth in Medicaid. But now, because of the severity of the situation, they’re eying many previously off-the-table scenarios.
States across the country are responding to a funding crisis in Medicaid, the government’s low-income health insurance program jointly paid for by the feds and state governments, Laura Tobler of the National Conference of State Legislatures, told New Mexico state lawmakers at an interim legislative committee meeting this week.
Tobler’s message to lawmakers was simple: You are not alone.
California cut provider payments. Florida reduced funding for nursing homes by 10.5 percent. Massachusetts reduced adult dental services for 600,000 recipients of its low-income health insurance program.
Some states are taking several tactics, from fighting against Medicaid fraud to making care for high-risk, high-cost patients more efficient.
New York, a state with a history of Medicaid fraud, recently modified its management information system to better identify improperly paid claims. At the same time that state has created pilot projects with a focus on treating chronically ill Medicaid beneficiaries.
South Carolina, meanwhile, decided to post Medicaid payment information online to try to guard against fraud. It has also reduced—from 34 to 31—the amount of pills in each monthly prescription for Medicaid enrollees.
Utah, which has already cut optional services, created a preferred drug list. Such lists show what prescription drugs are approved for payment. In many cases, the lists limit the drugs to a certain number of drugs in each category of treatment.
The cutting has begun
New Mexico has already begun to make cost-cutting measures, such as starting with capping the amount of money managed care organizations can spend on administrative costs, New Mexico’s Human Services Secretary Pam Hyde said Wednesday.
“The good news is that we’ve already done many of these things,” Hyde said of the cost-cutting steps. “The bad news is that we’ve done many of these things.”
In other words, state officials are now looking for more ways to trim spending, including eliminating many, if not all, optional Medicaid services.
Full story