FY 2010 Medicaid Budget Update Medicaid Advisory Committee

FY 2010 Medicaid Budget Update Medicaid Advisory Committee November 19, 2009

Included in FY 2010 Appropriation (GF) q q q q q PAC additional cost containment of 1% ($1. 2 M) 1% reduction in Hospital trends($5 M) Flat funding for most Provider reimbursement rates ($82 M) MCO 1% cost containment continued Hospital Day Limits $19. 2 M(TF) Increase UR review of Chronic Hospital impatient stays $3 M Accelerate Medicaid Hospital audits $1. 3 M HSCRC revision to the uncompensated care pool $4. 4 M Recover payments for Hospital preventable events $1. 5 M

July 2009 BPW Actions (GF) o o o o Recognize additional ARRA funding $75 M Improved PAC eligibility enforcement $1. 4 M Favorable rebidding of contracts $1 M Add ER to PAC benefits $3. 4 M Atypical antipsychotics on PDL $. 8 M Hospital Day limits $8. 9 M Provider rate reductions $10. 3 M MCO cost containment $6. 5 M

August 2009 BPW Actions (GF) o o o o Rate reduction for Community Based Providers $1. 1 M Rate reductions for other Providers $. 7 M Reduce MCO rate increase for January 2010 by. 5% $2. 7 M Hospital Day limits $4. 5 M Eliminate over the counter drugs in KDP $. 2 M Suspend eligibility in a timely manner for individuals upon incarceration and restore benefits upon release $1. 5 M Pay the lower of Medicare or Medicaid rates for services provided to people dually eligible for the programs. Change effective April 1, 2010 $3. 8 M Review and deny inappropriate ER, unnecessary one day stays and review for inappropriate out of state claims $2 M

November 2009 BPW Actions (GF) o o Recover funds from PAC MCOs for medical loss ratios below 80% in CY 2008 $2. 5 M Recover funds from MCOs for enrollees later determined to be ineligible $. 9 M Reduce Medicaid payments to hospitals $21 M Lower enrollment projection for MCHP $7 M