CMS Stepping Up Oversight Of States’ Medicaid Programs, Including Which Enrollees Are Pre- Or Post-Expansion
While the government will match rates of around 90 percent for expansion enrollees, for those who were enrolled pre-expansion the rates are much lower. The crackdown is part of a larger plan to cut improper payments within Medicaid. Other news on the program comes out of Iowa and California.
Modern Healthcare:
CMS To Increase Oversight Of Medicaid Enrollment, Managed-Care Plans
The CMS is ratcheting up scrutiny of state Medicaid programs. The agency announced Tuesday that it is boosting audits to confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees. "This imbalance in the federal matching rate creates financial risks for taxpayers by incentivizing states to shift cost to the federal government," CMS Administrator Seema Verma told reporters Tuesday. "This requires us to make sure that states are making accurate eligibility determinations." (Dickson, 6/26)
Des Moines Register:
Iowa Medicaid Chief Explains How Privatization Savings Figure Tripled
State experts simplified how they calculated savings under Iowa's private Medicaid management, tripling the savings estimates, Medicaid Director Mike Randol said Tuesday. The official savings estimates for the current budget year dropped 80 percent last fall, from $232 million to $47 million. Then, after Randol was hired as the program’s director, the estimate jumped to $140.9 million in May. (Leys, 6/26)
The Associated Press:
Brown Takes Victory Lap As He Signs California Budget
Gov. Jerry Brown will take a victory lap Wednesday when he signs a $139 billion California budget that marks a stark turnaround from the financial crisis he inherited seven years ago. Nearing the end of his final term as governor, Brown has celebrated the state’s financial strength and thriving economy, even as President Donald Trump and his allies paint the nation’s most populous state as a place in decline. ... The budget boosts funding for higher education, staving off tuition increases, and increasing welfare grants that have been slow to return to their pre-recession levels. It creates more slots for subsidized child care and gives a raise to doctors and dentists who see low-income patients on the state Medicaid program, Medi-Cal, which covers one in three Californians. (Cooper, 6/27)
Sacramento Bee:
California Budget Includes $176 Million For Hepatitis C Treatment For Medi-Cal Recipients, Inmates
Nowadays, the treatment period for hepatitis C programs is typically eight to 12 weeks and existing drugs have a 95 to 98 percent success rate in curing the infection, according to several Sacramento-area medical professionals. However, access to treatment is limited for low-income patients covered by Medi-Cal and for state prison inmates. (Holzer, 6/27)
