FY 2013 Medicaid Budget Update Medicaid Advisory Committee
FY 2013 Medicaid Budget Update Medicaid Advisory Committee April 26, 2012
Good news n n Physician fee increase intact Alcohol tax revenue used to support: n 300 new community waiver slots in OAW n 180 new community waiver slots in LAH n Increase in OAW case management support n No capping of the PAC program 2
Legislative Changes to Governor’s Budget, in General Funds n Increase Community LTSS Provider rates by 1. 5% n Reduced to 1% (Reduction of $. 9 M) n Fund the Chronic Health Home project for the full fiscal year § Reduced to six months; added $100, 000 for planning n Additional funds for personal care services…………………. . $2. 6 M through use of funding available from eliminating the Nursing Facility bedhold payments § Took full bedhold savings, but only reallocated 50% ($1. 3 M) back to personal care. Contingent on BRFA 3
Legislative Changes to Governor’s Budget, in General Funds (con’t) n MCO 1% reduction ………………. . … $15. 9 M n n Reduce the medically needy inpatient hospital benefit package …………………. $36 M n n Requires a report on how it will be implemented by 9/15/12 Implement tiered outpatient rates which means different rates for different types of services …. … $30 M n n Added an additional 1% reduction $15. 7 M Requires a report on how it will be implemented by 9/15/12 Implement a DSH pool ……………. . . $9. 1 M n Requires a report on how it will be implemented by 9/15/12 Contingent on BRFA 4
Legislative Changes to Governor’s Budget, in General Funds (con’t) n Nursing Home increased from 5. 5% to 6% ……………. $5. 5 M n Increased revenue estimate to $6. 9 M Contingent on BRFA n New Medical Day Care of 5. 5% ……………… $3. 4 M n Rejected 5
Legislative Changes to Governor’s Budget, in General Funds (con’t) n Reduce funding for non-emergency transportation…………………. ……$. 6 M n Delete funds for early takeover of MMIS…………$6 M n Tighten criteria for dental orthodontia program……………………. …. $. 3 M n Increase nursing home payments for targeted needs ……………………………. . $3 M 6
Budget Language and Narratives n Inform the Committees immediately if budgetary actions impact the Medicare Waiver and deteriorate Maryland’s position on the waiver test. Due by 12/1/2012 n n n Change the methodology for payment of the MCO Rural Access Incentive and report back on how to best do this. Due by October 15, 2012 Conduct a study that estimates the value of the tax exempt status enjoyed by not-for-profit nursing homes. Due by 1/1/2013 Study the use of Psychotropic medications among children in foster care. Due by December 1, 2012
“Doomsday” Budget Items n No rate increase for Mental Health providers n No rate increase for DD providers n Statewide reduction in 500 FTE n No COLA for state employees n Increased share of health insurance premiums for state employees 8
Additional Issues n “Doomsday” Budget itself not in balance, in the amount of $80 MM n Failure of BRFA to pass also causing deficit of $70 MM n As a result, across state government the budget is out of balance by $150 MM n Additional cuts therefore will be necessary 9
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