WeeklyFinancingNewsPulsefinal200900706.pdf (PDF | 393.43 kb)
SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 1 National Health Financing News HELP Committee Democrats Draft Lower Cost Bill With Public Plan Wal- Mart, SEIU, and Podesta Author Letter Supporting Employer Health Insurance Mandate Center for American Progress Releases Report Outlining Health Reform Financing Plan Pharmaceutical Companies Provide Details on Plan to Contribute $80 Billion to Health Reform IOM Panel Releases List of Top 100 Priorities for Comparative Effectiveness Research UnitedHealth Group Report Suggests IT Improvements to Help Finance Health Reform Rep . Davis Reintroduces Bill to Raise Age Limit for Children222s Coverage Under FEHBP Rep. Sanchez Proposes Bill to Allow Medicare to Pay for Adult Day Care Services Federal Government Releases Funding fo r Clinic Expansions CMS Proposes Reimbursement Increases for Primary Care, Changes Physician Reimbursement Calculations HHS Rescinds Three Medicaid Regulations, Delays Another Poll Finds Doctors Increasingly Using Online Tools; Online Visits Growing More Slowly CNN/Opinion Research Group Poll Finds Slim Margin of Support for Obama222s Plan Study Examines Medicare Part D222s Effect on O ther Medical Spending CDC Reports Analyze Health Coverage Data Study Examines Trends in Mental Health Admissions to Nursing Homes ComPsych Reports Most Customers Switching to 223Full Parity224 In Advance of Law Survey Highlights IT Gap Between Behavioral Health and General Health Care UCLA Releases Reports Examining Recent Health Reform Efforts in States A HRQ Releases State Snapshots GAO Report Examines Prescription Drug Cost Controls in Federal Programs KFF Brief Examines Recent Health Reform Polls Around the Hill: Hearings on Health Financing Around the States: State and Local Behavioral Health Financing News Arizona California Colorado Connecticut Georgia Illinois Indiana Iowa Kentucky Louisiana Maine Maryland Massachusetts Minnesota Mississippi Missouri Nebraska New Hampshire New Jersey North Carolina Ohio Pennsylvania Rhode Island Washington West Virginia Wisconsin Bec ause of t he July 4 holiday, the coverage period for this issue of SAMHSA222s Weekly Financing News Pulse ends Thursday July 2, 2009. For questions or comments, please contact Sarah Wattenberg (sarah.wattenberg@samhsa.hhs.gov). SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 2 National Health Financing News HELP Committee Democrats Draft Lower Cost Bill With Public Plan : In a letter to the Senate Health, Education, Labor and Pensions (HELP) Committee on July 1, Senator Edward Kennedy (D - MA) and Senator Chris Dodd (D - CT) said that that their revised health care pro posal would cost less than previous HELP Committee proposals and include a public plan and a large - employer health care mandate. The letter said that the Congressional Budget Office (CBO) estimated the price of the legislation to be $611.4 billion over 10 years, down from a previous estimate of $1 trillion (Financing News Pulse 6/22 edition). In addition, the employer mandate would apply to all employers with 25 employees or more and impose a $750 per - employee annual fee on companies electing not to provi de health insurance to their employees ( Kaiser Health New, 7/2 ; AP, 7/2 ). The CBO also determined that a long- term care program included in the HELP Committee legislation would produce $58 billion in revenue over 10 years but likely not remain profitable in the long - term. HELP Committee Democrats say the program is intended to buttress rather than compete with private long - term care insurance, providing only half the average cost of long - term care ( Kaiser Health News, 6/ 29 ; CQ Politics, 6/26 ). In related news, Senator Charles Schumer (D - NY) announced that he plans to introduce an amendment to the Senate Finance Committee health reform bill to include a public health plan. The Finance Committee222s health care reform legislation is likely to take a more bipartisan approach, utilizing a health insurance co - op system with government 223seed224 funding or a 223triggered224 public plan to be implemented onl y if the private insurance market fails ( Kaiser Health News, 7/2 ). Wa l -Mart, SEIU, and Podesta Author Letter Supporting Employer Health Insurance Mandate : On June 30, President and CEO of Wal - Mart, Mike Duke , President of the Service Employees International Union (SEIU), Andrew Stern , and Center for American Progress President, John Podesta delivered a letter to President Barack Obama supporting health care reform that includes an employer health insurance mandate for large companies ( Kaiser Health News, 6/30 ; Reuters, 6/30 ). Center for American Progress Releases Report Outlining Health Reform Financing Plan : On June 29, the Center for American Progress released a report outlining a plan to ensure that a $1.2 trillion health care reform proposal remains deficit neutral. The plan, endorsed by former senator Tom Daschle and Center for American Progress President John Podesta , supports taxing employer health benefits. Authored by Harvard University economics professor David Cutler and Georgetown University public policy professor Judy Feder , the report proposes holding national health care spending to a set growth rate and initiating fail- safe proposals for the following year if cost growth exceeds the pre - set limit ( Kaiser Health News, 6/29 ; New York Times, 6/29 ). Pharmaceutical Companies Provide Details on Plan to Cont ribute $80 Billion to Health Reform : On June 22, the Pharmaceutical Research and Manufacturers Association (PhRMA) agreed to contribute $80 billion to health reform over 10 years (Financing News Pulse 6/29 edition). The agreement, which health reform advocates are facing with increasing skepticism, would include $30 billion to help pay for prescription drugs under Medicare and $50 billion to pay for other reform. Under the deal, drug companies would increase the prescription drug discount they give Medic aid programs from 15.1 percent off the average wholesale price to 23.1 percent off, more than the 22.1 percent that President Obama proposed. The Medicaid savings are estimated to yield $30 to $35 billion over a decade. In addition, the industry agreed t o a federal approval process for generic biologic drugs that they estimate will cost pharmaceutical companies $9 billion and agreed to pay a 223health reform fee224 to SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 3 cover any difference in cost between the Medicare, Medicaid, and biogeneric cost savings and the $80 billion pledge ( Kaiser Health News, 7/1 ; Politico, 7/1 ). IOM Panel Releases List of Top 100 Priorities for Comparative Effectiveness Research: On June 30, the Institute of Medicine (IOM) released a list of the top 100 priorities for comparative effectiveness research. The IOM222s list is meant to influence the use of the $1.1 billion set aside for comparative effectiveness research in the American Recovery and Reinvestment Act (ARRA). The report included recommendations for research on numerous specific conditions, specific drugs, and general reduction of hospital- acquired infections ( Kaiser Health News, 7/1 ; AP, 6/30 . UnitedHealth Group Report Suggests IT Improvements to Help Finance Health Reform : On June 30, UnitedHealth Group Inc. released a report suggesting that the health care system could save $332 billion ov er 10 years by eliminating paper records, fully adopting electronic billing procedures, and embracing other IT improvements. The company estimates that 50 percent of the savings would go to hospitals and doctors, 20 percent to Medicare and Medicaid, and 30 percent to commercial payers ( Minneapolis/St. Paul Business Journal, 6/30 ). Rep. Davis Reintroduces Bill to Raise Age Limit for Children222s Coverage Under FEHBP : Prior to the July 4 Recess, Rep. Danny Davis (D - IL) reintroduced HR 2978 that would allow children to remain covered by their parents health insurance under the Federal Employees Health Benefits Program (FEHBP) up to age 25. The bill was most recently referred to the House Oversight and Government Reform Committee ( Government Executive, 6/25 ). Rep. Sanchez Proposes Bill to Allow Medicare to Pay for Adult Day Care Services : On June 25, Rep. Linda Sanchez (D - CA) introduced the Medicare Adult Day Care Services Act of 2009 to allow Medicare to pay for adult day care services. The bill would offer Medicare enrollees the choice of the currently available in- home care or adult day care services at 98 percent of the in - home care rate. The bill was referred to the House Ways and Means Committee ( McKnight222s Long- Term Care News & Assisted Living, 6/30 ). Federal Government Releases Funding for Clinic Expansions : On June 29, the federal government released $851 million in ARRA funds to expand and rehabilitate health clinics around the country. The ARRA set aside $2.5 billion for free and low - cost health clinics and two previous payments of $500 million have been issued already. Every clinic that applied for capital improvement funding will receive at least $200,000 ( Kaiser Health News, 6/30 ; New York Times, 6/29 ). CMS Proposes Reimbursement Increases for Primary Care, Change s Physician Reimbursement Calculations : On July 1, the Centers for Medicare & Medicaid Services ( CMS ) announced that it will remove the cost of physician- administered prescription drugs from its formula for determining doctors222 Medicare payments. In addition, CMS announced proposed fee changes that will raise Medicare payments to primary care physicians by 6 to 8 percent ( Bloomberg , 7/1 ; Wall Street Journal, 7/1 ; Kaiser Health News, 7/2 ). HHS Rescinds Three Medicaid Regulations , Delays Another : On June 29, the U.S. Depart ment of Health and Human Services (HHS) rescinded three controversial Bush Administration regulations governing Medicaid and delayed the application of a fourth, pending further review. One rescinded SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 4 regulation would have narrowed case management payments, another would have blocked Medicaid payments for administrative costs incurred by schools and for transporting Medicaid - enrolled children to school, and the third would have narrow ed the definition of 223outpatient224 for Medicaid services. The fourth regulation, which HHS has yet to rescind but has delayed until June 30, 2010, would limit the taxes that states impose on Medicaid providers to pay for their Medicaid programs ( Kaiser Health News, 6/30 ; CQ Politics, 6/29 ). Poll Finds Doctors Increasingly Using Online Tools; Online Visits Growing More Slowly : A poll conducted by Ma nhattan Research, a unit of Decision Resources Inc., found that 39 percent of doctors reported communicating with patients online this year, up from 16 percent five years ago. The firm found that the majority of web - based contact was for billing, appointment scheduling, and delivery of lab results. The American Academy for Family Physicians reports that 3 percent of their members perform online visits ( Kaiser Health News, 6/30 ; Wall Street Journal, 6/30 ). CNN/Opinion Research Group Poll Finds Slim Margin of Support for Obama222s Plan : A CNN/Opinion Research Group poll, released July 1, found that 55 percent of people believe that the health care system needs a great deal of reform and 40 percent believe that at least some reform is needed. The poll also found that 51 percent favor President Obama222s health care plan and 45 percen t oppose it. Finally, the survey found that 54 percent of respondents worry that their health care costs will go up as a result of health care reform and only 20 percent of respondents believe that their families will be better off under President Obama222s plan ( Kaiser Health News, 7/1 ; CNN, 7/1 ). Study Examines Medicare Part D222s Effect on Other Medical Spending : A study published in the New England Journal of Medicine (NEJM) examines the effect of the Medicare Prescription Drug Benefit (Part D) on other Medicare spend ing. The study concludes that, for people who previously had little or no prescription coverage, savings on other medical care approximately offset the costs of extending prescription coverage to Medicare enrollees. However, the study also found that medical spending increased in the group with the most generous prescription coverage ( Kaiser Health News, 7/2 ). CDC Reports Analyze Health Coverage Dat a : On Jul y 1, the Centers for Disease Control and Prevention (CDC) released a report examining insurance trends from 1959 to 2007 and a report containing early estimates from the 2008 National Health Interview Survey . The reports show that the number of privately insured non - elderly Americans has declined in the past year, with a bout 65 percent of non - elderly Americans holding pr ivate health insurance in 2008 227 down from 67 percent in 2007 and 80 percent in the 1970222s and early 1980222s. However, the CDC also reports that public coverage for adults is rising in some states due largely to Medicaid expansions. The reports also address insurance c overage in the 20 largest states ( Kaiser Health News, 7/2 ; AP, 7/1 ). S tudy Examines Trends in Mental Health Admissions to Nursing Homes : An article in the July 2009 issue of Psychiatric Services examined trends in mental health admissions to nursing homes from 1999- 2005, finding that the number of nursing home residents admitted with mental illness has overtaken the number admitted with dementia. The study also found an increasingly high prevalence of depression among nursing home populations. The authors attributed the findings to increasing awareness of depression and additional non - nursing home alternatives for individuals with dementia. They also suggest that these results should inform resource allocation and planning for the country222s nursing homes. SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 5 C omPsych Reports Most Customers Switching to 223Full Parity224 In Advance of Law : ComPsych Corporation , the largest supplier of Employee Assistance Programs (EAPs), reports that the majority of its customers are altering their benefit plans to comply with the Paul Wellstone and Pete Domenici Mental Health Party and Addiction Equity Act of 2008 that is set to take effect January 1, 2010. ComPsych reports that most of its clients are switching their benefit plans to include 223full parity224 to comply with the law222s requirement that plans offering mental health and substance abuse benefits offer equal benefits that are equal to general medical coverage, including copayments, and treatment limitations ( PRNewswire, 6/29 ). S urvey Highlights IT Gap Between Behavioral Health and General Health Care : The Behavioral Health/Human Services Information Systems Su rvey, conducted by Centerstone Research Institute for the Mental Health Corporations of America, the National Association of Psychiatric Health Systems , the National Council for Community Behavioral Health Care , and the Software and Technology Vendors Asso ciation , found that behavioral health services spend half as much on IT as do general health services. The survey also found that M/SU entities employ one- third as many IT professionals as general care entities and that fewer than half of M/SU providers surveyed had clinical electronic health records (EHR) systems ( Healthcare IT News, 6/29 ). UCLA Releases Reports Examining Recent Health Reform Efforts in States : In June, the University of California, Los Angeles222 (UCLA) Center for Policy Research released two reports , 223Swimming Upstream: The Hard Politics of Health Reform in California,224 and 223Politics and Policy in State Health Reform.224 The reports examine recent health reform efforts in California, Illinois, Massachusetts, New York, and Pennsylvania ( Kaiser Health News, 7/2 ). AHRQ Releases State Snapshots: The Agency for Healthcare Research and Quality (AHRQ) released its annual state snapshots tool , pr oviding information on health care quality in each state. The snapshots highlight states222 strengths, weaknesses, and opportunities for improvement in the provision of health care ( AHR Q, 6/26 ; Kaiser Health News, 7/2 ). GAO Report Examines Prescription Drug Cost Controls in Federal Programs : On June 24, the Government Accountability Off ice (GAO) released a report , 223Overview of Approaches to Control Prescription Drug Spending in Federal Programs,224 examining prescription drug cost - control mechanisms in Medicare Part D, Medicaid, the Veterans Health Administration, the Department of Defense (DoD), and the FEHBP ( Kaiser Health News, 7/2 ). KFF Brief Examines Recent Health Reform Polls : On July 2, the Kaiser Family Foundation (KFF) released a brief analyzing the results of recent health care reform polls. Around the Hill: Hearings on Health Financing Congress is out of se ssion for the July 4 recess. The Senate reconvenes at 2 p.m. July 6 and the House reconvenes at 2 p.m. July 7. SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 6 Around the States: State and Local Behavioral Health Financing News Arizona Update: Governor Approves Basic Budget Deal with Line- Item Vetoes, Rejects Supplemental Bills, Calls Special Session : On July 1, Governor Jan Brewer (R) signed the state222s basic budget trailer, line item vetoing spending cuts for numerous departments including the Department of Health Services . In addition, Governor Brewer vetoed seven companion budget bills including one that allocated $4 billion in education funding and called a special legislative session for July 6 to resolve the lingering budget issues ( Arizona Republic, 7/2 ; Arizona Republic, 7/2 ; Ahwatukee Foothills News, 7/1 ). California State Fails to Pass Budget, Begins Issuing IOUs : The California Legislature and Governor Arnold Schwarzenegger (R) failed to reach a budget compromise for the fiscal year that began July 1 and the Senate failed to pass three emergency bills that would have altered school funding commitments to avert an immediate funding shortage. As a result, the state222s budget deficit is now roughly $27 billion and on July 2 the state began paying $53.3 million of its debts with IOUs. The IOUs, which are currently paying individual tax refunds, state vendors, and local governments, offer recipients an interest rate of 3.75 percent. If the Legislature and the governor fail to reach a compromise this month, the state will be forced to issue $3.36 billion in IOUs over the month of July. The state is not permitted to pay for Medicaid, schools, or state employee salaries with IOUs ( New York Times, 7/2 ; San Francisco Chronicle, 7/2 ). San Francisco Board of Supervisors, Mayor Agree on Budget : The San Francisco Board of Supervisors222 Budget Commi ttee reached an agreement with Mayor Gavin Newsom (D) to make $43.7 million in changes to the budget Mayor Newsom proposed June 1 (Financing News Pulse 6/8 edition). The changes focus on reducing planned cuts to health and human services programs including substance abuse centers ( San Francisco Chronicle, 7/2 ). San Joaquin County Passes Budget, Cuts Health Care Funding : The San Joaquin County Board of Supervisors passed a $1.27 billion operating budget for the coming fiscal year, asking each department to cut general fund spending by 12 percent. Funding for HIV education, disease prevention, immunizations, and San Joaquin General Hospital will be reduced because o f the cuts. In addition, the county says further cuts may be required after California passes a state budget ( Contra Costa Times, 6/26 ). Watchdog Group Sues State Over Application of Mental Health Law : Consumer Watchdog, a Santa - Monica insurance advocacy group, is suing the California Department of Managed Health Care over a recent decision that allows California insurance companies to avoid paying for some of the most costly autism treatments. In 1999, the state adopted the Mental Health Parity Act, requiring health insurance companies to cover mental health conditions on an equal basis with general health conditions; however, in March, the state ruled that certain behavior modification therapies 227 that often cost up to $70,000 annually 227 do not constitute health care services and consequently need not be covered by health SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 7 insurers. Consumer Watchdog222s suit, filed in Los Angeles County Superior Court, argues that the state222s de cision has resulted in a negative reversal of outcomes ( Los Angeles Times, 7/1 ; K aiser Health News, 7/1 ). Lake County Mental Health Department to Terminate Building Lease: On June 30, the Lake County Board of Supervisors gave the county222s Mental Health Department permission to terminate a lease in one of its locations and will consider terminating a least a second location. Together, the moves are expected to save the county $204,505 in FY2009- 2010 and $237,060 in FY2010 - 2011. The moves are part of the department222s plans to cut $500,000 in spending a result of decreased state funding ( Lake County News, 6/27 ). San Jose Mercury News Offers Medicare Cost Comparison Tool: Using Medicare data from 2000 through 2006 analyzed by the Dartmouth Atlas of Health Care and the Mercury News, the San Jose Mercury News is offering a utility that allows users to compare average Medicare per- patient costs by zip code. Colorado CMS Audit Prompts Medicaid Reimbursement Changes : As a result of a CMS audit that determined Medicaid funding was being allocated inconsistently, the Colorado Department of Human Services adjusted the calculations for numerous Medicaid services effective June 30. Among the changes, the developmental disabilities division recalculated its payment rates to use a new model based on the level of patient disability and imposing certain caps and restrictions. Some services, including transportation and work programs for individuals with developmental disabilities, will see funding cut while others will see it increased ( Kaiser Health News, 7/1 ; Colorado Springs Gazette, 6/30 ). Medicaid Fraud Unit Recovered Over $5 Million: On June 30, Colorado Attorney General John Suthers announced that the state222s Medicaid Fraud Control Unit has recovered over $5.3 million through Medicaid fraud settlements and restitutions during FY2009 ( Denver Business Journal, 6/30 ). Mental Health Center Receives Grant , Other Assistance : Mesa County is giving Co lorado West Mental Health a $900,000 Colorado Department of Local Affairs grant to allow them to rent a facility for operations. In addition, to cope with the agency222s $10 million debt, the Colorado Health Foundation has negotiated the debt down to $6.9 m illion which it will pay in return for $750,000 from the center over five years ( Daily Sentinel, 6/27 ; Daily Sentinel, 6/30 ). Connecticut Update: Governor Vetoes State Budget, Issues Executive Order to Avoid Shutdown: On July 1, Governor M. Jodi Rell (R) vetoed the two - year $37 billion Democratic bu dget approved by the Connecticut Legislature . The state will operate under an executive order issued by Governor Rell until a budget is passed ( Hartford Courant, 7/2 ). Hospital to Reimburse Medicare for Improper Billing : Yale - New Haven Hospital has agreed to refund Medicare an additional $885,953, bringing its total Medicare refunds for improperly billed procedures to SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 8 $3.2 million. The hospital prefor med its own review and offered the reimbursements after being notified of a single erroneous billing for the procedure in question ( Hartford Courant, 7/2 ; New Haven Register, 7/2 ). Georgia State Health Agencies Overhaul Takes Effect : A plan to overhaul Georgia222s health agencies, approved by Governor Sonny Perdue (R) on May 4, took effect on July 1 ( Atlanta Journal Constitution, 6/28 ). Under the plan, the Department of Human Resources split into three distinct agencies, a Department of Behavioral Health and Developmental Disabilities (DBHDD) , a Department of Community Health (DCH) , and a Department of Human Resources (DHR). The DCH, headed by current Community Health Commissioner, Dr. Rhonda Medows , will handle Medicaid, PeachCare, and other public health program s while the reformed DHR will focus on child, family, and elderly services and be headed by Commissioner B.J. Walker . Dr. Frank Shelp, clinical director of Georgia Regional Hospital in Savannah, will head the DBHDD (Financing News Pulse 5/4, 4/13, 3/13 ed itions). Illinois Governor Vetoes Budget Over Health Funding and Budget Shortfalls : On July 1, Governor Pat Quinn (D) vetoed SB 1197, part of the Legislature222s budget which Governor Quinn says leaves the state a $9.2 billion budget shortfall227 closing onl y a fraction of the state222s projected $11.6 billion budget gap. The governor said the bill would fail to fund basic services; however, his veto leaves social service funding in jeopardy. The state will halt payments to health providers 227 including M/SU pr oviders throughout the state227 and the governor has not created contingency contracts to promise eventual payment of state funds. Nine social service organizations have sued the state as of July 1 ( Chicago Tribune, 7/2 ; Chicago Sun Times, 7/1 ; Danville Com mercial- News, 7/1 ). Chicago222s Mental Health Billing Issues Partially Resolved: Billing problems that forced the temporary closure of four of Chicago222s 12 mental health centers have been partially resolved (Financing News Pulse 4/13, 3/20 editions). A ccording to the Illinois Department of Human Services , which cut off funding for the city222s centers because of billing problems earlier this year, the Chicago Department of Public H ealth is still not billing for all of its mental health services; however, they are working to correct the errors in their new billing system and have made serious progress ( Chi Town Daily News, 7/2 ). Peoria County Receives Funding for Mental Health Court : Peoria County will receive $500,000 in funding to create a mental health court. The county will supply the space and services for the court ( CIProud , 6/29 ). Indiana Legislature Reaches Budget Compromise, Governor Signs Budget : On June 30, Governor Mitch Daniels (R) signed a $28.7 billion two - year state budget after the Indiana General Assembly passed the budget June 29 ( Chicago T ribune, 7/1 ). The action comes after Indiana lawmakers failed to pass a budget during the regular session. During much of the subsequent special session, the House sought a one - year $14.5 billion budget (Financing News Pulse 6/29 edition). SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 9 Iowa State Awarded $10.5 Million for Alcohol Abuse Prevention: The Substance Abuse and Mental Health Services Administration222s (SAMHSA) Center for Substance Abuse Prevention ( CSAP) awarded the Iowa Department of Public Health $10.5 million over five years to fund substance abuse prevention coalitions in the state ( Iowa Politics, 7/2 ). Kentucky Baxter Settl es Over Medicaid Pricing : On July 2, Kentucky Attorney General Jack Conway announced a $2 million settlement with Baxter International Inc. over inflated average drug prices for the company222s IV solutions. The settlement is another in a series stemming fr om lawsuits Conway filed against 47 pharmaceutical companies for Medicaid overcharging (Financing News Pulse 6/1, 3/13 editions) ( Business First of Louisville, 7/2 ). L ouisiana Governor Signs Budget, Vetoes Some Health Funding Allocations : After the Louisiana Legislature approved a $28 billion state budget on June 25 (Financing News Pulse 6/29 edition), Governor Bobby Jindal (R) signed the budget, making 53 line item ve toes. Governor Jindal vetoed $14.2 million earmarked for the New Orleans Adolescent Hospital, likely closing the mental health facility on September 1. However, the Department of Health and Hospitals (DHH) says the $14.2 million will be redirected within the mental health budget and that the 35 inpatient beds at the facility will be shifted to Southeast Louisiana Hospital ( Times Picayune, 7/1 ). The state222s budget also cuts Medicaid reimbursements by about $180 million, reducing the Medicaid budget from $4.43 billion to $4.25 billion. However, the impact of the cuts is difficult to forecast until DHH issues new rules governing the reimbursements ( AP via Town Talk, 7/1 ; Kaiser Health News, 7/1 ). Maine CMS Says Hospital Will No Longer Rece ive Medicare and Medicaid Reimbursements : After numerous compliance violations dating back to January 1, 2008, CMS has informed Down East Community Home Hospital that it will no longer be eligible for Medicaid or Medicare reimbursements beginning July 10. CMS did not request a correction plan from the hospital but hospital officials are working with the Maine Department of Health and Human Services in an attempt to correct the problems ( MPBN, 6/26 ; Bangor Daily News, 6/26 ). Maryland Medicaid Eligibility Expansion Causes Higher - Than- Expected Enrollment and Cost : In July 2008, Maryland raised the Medicaid income eligibility limit for parents from 40 percent of the federal poverty level (FPL) to 116 percent of the FPL. At the time, the expansion was estimated to add 26,605 residents to the Medicaid program at a cost of $94.6 million in combined federal - state funding; however, as of July 1, 44,255 residents had enrolled in the program at an estimated cost of $144.6 million ( Baltimore Sun, 7/2 ; Kaiser Health News, 7/2 ). SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 10 Massachusetts Governor Signs $27 Billion State Budget : On June 29, Governor Deval Patrick (D) signed a $27 billion state budget, appro ved by the Massachusetts Legislature last week (Financing News Pulse 6/29 edition). The governor line item vetoed $147 million in spending but also submitting a separate $269 million supplemental budget to fund other initiatives, including one expanding h ealth care for 30,000 legal immigrants. The new state budget maintains current eligibility standards for the state222s subsidized health care, funds dental coverage under MassHealth and Commonwealth Care, and raises the sales tax by 25 percent ( AP via Boston Herald, 6/29 ; Boston Globe, 6/29 ; WBUR, 6/29 ). Poll Found Few Residents Believe Health Reform was Successful : A poll conducted in April by Rasmussen Reports found that only 26 percent of likely voters in Massachusetts felt the state222s health care reform was a success and only 21 percent believe health reform made health care more affordable. Most people perceived little or no effect of the state222s health reform bill, with 37 percent reporting they were unsure whether it was a success or failure, 44 percent reporting no change in health care affordability, and 53 percent reporting the same or similar health care quality ( Boston Herald, 6/29 ; Kaiser Health News, 6/30 ). Minnesota Governor Alters Planned Cuts to M/SU Grants : On June 25, Governor Tim Pawlenty (R) made slight changes to his 223unallotment224 plans to cut $236 million from the state222s health and human services funding (Financing News Pulse 6/22, 5/26 editions). Governor Pawlenty announced that he will spare some ch emical dependency grants that he had previously targeted for cuts but will cut more funding from mental health grants and community services block grants ( KTTC, 6/26 ). Mississippi Governor, Legislature Agree on Medicaid Funding : On June 30, the Mississippi Legislature and Governor Haley Barbour (R) agreed to a plan to close the FY2009 Medicaid shortfall and fund Medicaid in coming years. Medicaid funding had been a central sticking point of budget negotiations and Governor Barbour only gave the Legislature permission to vote on the issue in this week222s special legislative session after the compromise was reached (Financing News Pulse 6/29, 6/8, 6/1, 5/26, 5/11 editions). Under the compromi se, hospitals will pay a $60 million tax this year that will gradually increase to $90 million as Medicaid funding from the ARRA decreases. In addition, the compromise plan allows the governor to balance any future Medicaid deficits with budget cuts ( Jackson Free Press, 7/1 ). Missouri State Passes Budget, Governor Vetoes Some Spending, Adds New Programs : After the Missouri Legislature passed a $2 3 billion operating budget and a supplemental $600 million capital improvements bill, Governor Jay Nixon (D) vetoed $105 million in spending on June 25 and placed another $325 million on hold. Among Governor Nixon222s cuts was a planned Medicaid rate increase for dentists that was slated to cost the state $3.6 million. In addition, the governor outlined a plan to give $40 million to public universities and community colleges to expand health education (Financing News Pulse 6/15 edition) ( Belleville News - Democrat, 6/ 28 ; AP via Forbes, 6/25 ; Kan sas City Business Journal, SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 11 6/25 ). The budget also transfers control of the Mid - Missouri Mental Health Center from the state to University of Missouri , changing its name to the Missouri Psychiatric Center (Financing News Pulse 4/13 edition) ( Columbia Daily Tribune, 6/30 ). Nebraska Judge Strikes Down State222s Medicaid Work Mandate: On June 30, a Lancaster County District Court Judge ruled that the Nebraska Department of Health and Human Services exceeded its authority when it approved a rule requiring Medicaid recipients to work a set number of hours in order to remain Medicaid - eligible. Under the rule that the judge struck down, single parents with children older than six were required to work at minimum of 30 hours a week to receive Medicaid and dual parent households had to work a combined 35 or 55 - hour week depending on their level of federally funded childcare. It is unknown how many residents will regain Medicaid coverage as a result of the ruling ( AP via Forbes, 7/2 ). New Hampshire Governor Signs State Budget, Funding i n Jeopardy : On June 30, Governor John Lynch (D) signed the $11. 5 billion state budget, approved by the New Hampshire Legislature June 23. The budget scales back retiree health insurance benefits and increases the premiums for retiree health care for state employees under age 65 as well as calling for $100 million in cuts, largely from the Department of Health and Human Services (Financing News Pulse 6/29 edition) ( Nashua Telegraph, 7/1 ). In addition, the budge t relies on a $110 million surplus in the state fund that underwrites the state222s Medical Malpractice Joint Underwriting Association , created in 1975 to provide malpractice insurance not otherwise available (Financing News Pulse 4/27 edition). However, a county Superior Court judge has blocked the state222s access to the money until she rules on a lawsuit brought by the New Hampshire Medical Society alleging the state does not have the right to access the funds ( Nashua Telegraph, 7/1 ). New J ersey Governor Signs State Budget, Elects to Continue Parent Enrollment in Insurance Program : On June 29, Governor Jon Corzine (D) signed a $29 billion budge t, passed by the New Jersey Legislature on June 25 (Financing News Pulse 6/29 edition). The budget reduces state spending by $4 billion and relies on $2.25 billion in ARRA funds, allocating $274 million for the Division of Mental Health ( Philadelphia Business Journal, 6/29 ; AP via Forbes, 6/29 ). Governor Corzine also elected not to freeze parent al enrollment in the state222s health insurance plan for working families, NJ FamilyCare, or delay the expansion as he planned (Financing News Pulse 4/13 edition). The move would have saved the state $9 million; instead family care eligibility will go from 150 percent of the FPL to 200 percent of the FPL ( Star - Ledger, 6/30 ). North Carolina Update: Legislature Fails to Pass Budget : Unable to pass a state budget by the July 1 deadline, North Carolina will operate on a temporary spending plan that expires July 15. Legislators will not work over the July 4 recess but plan to resume budget talks on July 6 ( News &Observer, 7/2 ; Chronicle, 7/1 ). SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 12 Ohio Update: Legislature Passes Interim Budget : Fai ling to pass a budget by the beginning of the fiscal year, the Ohio Legislature passed an interim budget on June 29 that will keep the state running through July 7 ( Columbus Dispatch, 7/1 ; Plain Dealer, 6/29 ). Clark County Seeks to Renew Mental Health Levy : Mental Health Services of Clark County is seeking to renew the county222s 1 - mil mental health levy for an additional 10 years. The levy would cost the average homeowner $30 annually and generate $2 million for agency, about 12 percent of the agency222s budge t. The levy will go to a popular vote in November ( Springfield News - Sun, 6/26 ). Mental Health Facility Expands : With a $460, 000 grant from the Ohio Department of Mental Health and a match from the Community Mental Health and Recovery Board, Main Place in Newark plans to expand its mental health facility. The agency must raise an additional $60,000 to fund the project, which it expects to complete by December 30 ( Newark Advocate, 6/27 ). Salem Secures Lower Insurance Rates Through Wellness Programs : Salem222s health insurance rates through Emplo yer222s Resource Council/ Anthem BlueCross BlueShield will remain the same for the year that began July 1, 2009 and ends June 30, 2010. The city was able to avoid a premium rate increase and secure a 3 percent premium discount because city employees participated in health fair days, health questionnaires, and wellness check - ups ( Salem News, 6/28 ). Pennsylvania Legislators Fail to Pass Budget, State Warns Medicaid Provide rs : The Pennsylvania Legislature recessed for the July 4 break without approving a spending plan for the new fiscal year. As a result, the state warned numerous vendors 227 including hospitals and nursing homes 227 that they will not be paid on time. Until the state passes a budget, it cannot reimburse Medicaid providers for their services ( AP via Philly.com, 7/1 ). Pew Report E xamines Rising Cost of Philadelphia Employee Benefits : On June 29, the Pew Charitable Trusts and the Economy League of Greater Philadelphia released a report examining the rising costs of employee pension and health insurance obligations for the city. The report notes that the city222s pension fund is currently only 50 percent funded while the city222s spending on pensions and health care is expected to rise from $830 million this year to $1.1 billion by 2013 227 a 21 to 26 percent increase ( Phil adelphia Inquirer, 6/30 ). Rhode Island Update: Governor Signs Budget : On June 30, Governor Donald Carcieri (R) signed a $7.78 billion state budget passed by the by the Rhode Island Senate on June 26 and the House on June 25 (Financing News Pulse 6/29 e dition). In addition to raising numerous taxes that Governor Carcieri opposes, the budget also eliminated the governor222s proposed cuts to the Pharmaceutical Assistance for the Elderly program and to dental services for low - income residents under RIte care (Financing News Pulse 6/29 edition; Providence Journal, 7/1 ; AP via MSN, 6/30 ; Providence Business News, 6/28 ). SAMHSA222s Weekly Financing News Pulse July 6, 2009 7/6/09 13 Washington Health Care Costs Expected to Create Budget Shortfall : On July 2, the Caseload Forecast Council and the governor222s budget office released an estimate indicating that funding Medicaid and children222s health care over the next two years will create a $250 million budget shortfall. Of the $250 million, $113 million is expected to finance Medicaid and an additional $69.6 m illion is expected to pay for other children222s coverage ( News Tribune, 7/2 ). Health Center Receives ARRA Funding for M/SU and EHRs : The Valley View Health Center will receive $504,76 5 in ARRA funding for its four Washington locations. The center plans to use the funding to double the size of one of its clinics, pay for behavioral health services, and cover some of the bills for an EHR system to be implemented across all of the center 222s locations ( KELA, 6/28 ).l West Virginia CMS Demands Share of 2004 Medicaid Settlement : CMS is seeking the federal share of an $850,000 set tlement that West Virginia Attorney General Darrell McGraw reached with pharmaceutical manufacturer Dey, Inc . CMS is seeking $446,607, less than the $634,525 the agency withheld from West Virginia222s Medicaid program in 2007 ( West Virginia Record, 6/29 ). Wisconsin Governor Signs $62 Billion State Budget : On June 29, Governor Jim Doyle (D) signed a two - year $62 billion state budget designed to close the state222s projected $6.6 billion deficit. Governor Doyle line item vetoed 81 measures, eliminating about $10 million in state spending. The budget continues funding for the state222s BadgerCare Plus program that provides health care for low - income reside nts and cuts 2 percent across - the - board from all state agencies ( Business Journal of Milwaukee, 6/29 ; AP via CBS, 6/30 ). The budget also requires insurance companies to cover autism and mental health disorders ( Apple ton Post - Crescent, 6/24 ).
