Kaiser Daily Health Policy Report Examines Developments Related to Medicaid

The following summarizes news coverage of Medicaid developments in Florida, Georgia, New York, North Carolina and Tennessee.

• Florida: The state Legislature on Monday began a five-day special session that will address, among other topics, Gov. Jeb Bush's (R) Medicaid reform plan, the Orlando Sentinel reports (Kennedy, Orlando Sentinel, 12/5). HHS Secretary Mike Leavitt in October approved a waiver for the plan, which will shift the 2.2 million Medicaid beneficiaries in the state to managed care and cap per-beneficiary state expenditures to help reduce costs. The waiver will allow Florida to implement the plan as a demonstration project in select counties. The plan requires final approval by the state Legislature (Kaiser Daily Health Policy Report, 10/20). According to the Sentinel, the plan "remains clouded in controversy," with opponents expressing concern about the HMOs' role, the status of indigent care payments to hospitals and federal Medicaid matching funds. However, the "Republican-controlled" state Legislature "appears poised to embrace" the reforms, according to the Sentinel (Orlando Sentinel, 12/5).
  
  
• Georgia: Gov. Sonny Perdue (R) on Friday implemented a new income-eligibility verification system for the state's Medicaid program, the Atlanta Journal-Constitution reports. Under the changes, individuals applying for the family Medicaid program in Georgia after Jan. 1, 2006, will have to present proof of income -- such as a W-2 form, pay stub or income tax return -- before they can begin receiving benefits. Currently, individuals applying for Medicaid in the state self-declare their income status on their applications and can begin receiving benefits while the state verifies their eligibility, according to Julie Kerlin, a spokesperson for the state Department of Community Health. About 2% to 3% of Medicaid beneficiaries are found to be "eligible in error" because they lied about their income or produced other false information, according to the state. The new policy will not apply to pregnant women and newborns, who will be able to receive immediate prenatal and postnatal care without waiting for eligibility verification (Guthrie, Atlanta Journal-Constitution, 12/3).
  
  
• New York: The administration of Gov. George Pataki (R) last week applied to HHS for renewal of a Medicaid waiver that allows facilitated enrollment in Medicaid (Perez-Pena, New York Times, 12/6). The program allows HMOs, community groups and health clinics to help New York state residents apply for Medicaid benefits. In the past five years, it has helped increase the number of state residents enrolled in Medicaid by more than one million individuals (Kaiser Daily Health Policy Report, 11/23). According to the Times, it is unclear whether HHS will approve the waiver renewal. The state already has requested a $1.5 billion federal grant to help pay for hospital closings, a move New York officials fear could decrease the state's chances of receiving the renewal (New York Times, 12/6).
  
  
• North Carolina: The Raleigh News & Observer on Sunday profiled Allen Dobson, director of the state Division of Medical Assistance, who this year "became the first doctor to run the state's Medicaid program." The article includes an overview of some of Dobson's cost-saving efforts, including encouraging doctors to be more conservative in their prescribing habits and tracking prescription drug prescribing, as well as expanding Community Care, a state system of local health care networks that treat children and pregnant women (Bonner, Raleigh News & Observer, 12/4).
  
  
• Tennessee: Tennessee Gov. Phil Bredesen (D) on Tuesday proposed expanding coverage in TennCare, Tennessee's Medicaid managed care program, beginning in February to people with high medical bills who lack health insurance, the Tennessean reports. The plan, which must be approved by the federal government, would allow the state to expand enrollment in TennCare's "medically needy" program from the current level of 91,000 to 100,000. The plan also would allow individuals to enroll in the program sooner, for longer periods of time and with more relaxed eligibility requirements than state officials previously proposed, according to the Tennessean. TennCare Director J.D. Hickey said the expansion could cost the state $20 million in the current fiscal year. The expansion could affect some of the 191,000 adults who recently lost TennCare coverage, but it is not clear how many would be eligible, according to the Tennessean (Wadhwani, Tennessean, 12/7). In other TennCare news, the state Department of Human Services by Dec. 13 expects to complete 2,000 pending appeals hearings for state residents who were removed from the program. The department had held about 3,300 hearings as of Nov. 21, according to DHS spokesperson Michelle Mowery Johnson (AP/Memphis Commercial Appeal, 12/3).