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Morning Briefing

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Tuesday, Apr 14 2015

Full Issue

Ky. Seeking New Managers For Medicaid Managed Care; Ill. Medicaid Cuts Threaten Group Of Small Hospitals

In other state Medicaid news, Connecticut's Medicaid audit processes draw criticism and lawmakers' scrutiny; North Carolina's audit finds $350 million in liabilities and a financial examination in Missouri finds the state owes the federal government $34 million.

In a step intended to address concerns of patients and providers, the state has decided to seek bids for new standardized contracts to manage the massive Kentucky Medicaid program. ... The new contracts, Haynes said, will incorporate many improvements including increasing oversight of denial of claims, offering managed-care companies incentives to decrease overuse of emergency rooms, and encouraging the companies to help in the expansion of behavioral health services. (Loftus, 4/13)

A group of Chicago-area hospitals facing dramatic cuts in state funding under Gov. Bruce Rauner’s first budget emphasized the dire situation of community health care in a meeting Monday with legislators at Norwegian American Hospital. Rauner’s plan to cut more than $1.5 billion from Medicaid — with over $800 million coming from hospitals — has leaders of hospitals such as Loretto in the Austin neighborhood concerned they will have to significantly limit services or just shut their doors. (Novak, 4/13)

Critics say the audits are making some pharmacists, doctors and other providers consider dropping out of Medicaid. And some wonder if DSS has become more aggressive in auditing as a way to fill the state’s coffers to help cope with tight budgets. (Levin Becker, 4/14)

The state Medicaid program had accumulated $350 million in liabilities as of June 30 last year, about the same time that state health officials were boasting of a $63 million budget surplus in the government health insurance program. The difference represents cash-on-hand vs. money owed. The state Auditor’s Office released a two-year detailed balance sheet for the state Department of Health and Human Services, an accounting of department finances that state Auditor Beth Wood said had not been done in 20 years. (Bonner, 4/13)

Federal health regulators have given preliminary certification approval to NCTracks, the state’s controversial Medicaid claim payment system. The N.C. Department of Health and Human Services announced Sunday it was notified Friday by the Centers for Medicare and Medicaid Services. Officials expect formal notification within a week. ... The CMS preliminary approval comes nearly two years after DHHS launched NCTracks in July 2013. At a $484 million contract cost for development, implementation and support, it represents the biggest information technology project in state government history. (Craver, 4/13)

North Carolina's computer billing system for Medicaid claims has met the federal government's accuracy standards nearly two years after it first came online. The state Department of Health and Human Services announced that NCTracks has earned certification from the Centers for Medicare and Medicaid Services. That means the federal government will cover more of the billing system's operating costs, retroactive to when NCTracks began in 2013. The state will get $19 million more in federal funding. (4/14)

A new audit recommends that Missouri refund more than $34 million to the federal government because the state did not comply with Medicaid regulations. For at least three years, the state failed to bill drug manufacturers for rebates the companies owed on drugs administered by physicians at a hospital, according to the audit scheduled for release Tuesday by the Office of Inspector General of the U.S. Department of Health and Human Services. (Shapiro, 4/14)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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