SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 1, 2010 12/1/2010 1 SAMHSA222s Weekly Financing News Pulse: State and Local Edition Arizona California Florida Idaho Illinois Louisiana Massachusetts M ichigan Montana N ebraska New York R hode Island South Carolina Washington To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/se rvice/multi_subscribe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For quest ions or comments, please contact Rasheda Parks ( Rasheda.Parks@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 1, 2010 12/1/2010 2 Around the States: State and Local Behavioral Health Financing New s Arizona State to Cut Medicaid Reimbursement Rates by 5 Percent : Using authority granted by the FY2011 budget, Arizona Health Care Cost Containment System (AHCCCS) officials have announced that they will cut Medicaid reimbursement rates for hospitals, physicians, and other health care providers by 5 percent beginning April 1. AHCCCS officials have already frozen reimbursement rates but say the cuts are necessary to offset lower -than -anticipated American Recovery and Reinvestment Act (ARRA) Federal Medical Assistance Percentage (FMAP) funding. AHCCCS officials have also frozen enrollment in Arizona222s Children222s Health Insurance Program (CHIP), KidsCare, and reduced Medicaid benefits ( AP via Business Week, 11/24 ). California Update: 23 Counties File Suit Against California Over Mental Health Funding Veto : Twenty -three counties have filed suit against California over mental health cuts instituted when Governor Arnold Schwarzenegger (R) signed the state222s $87.5 billion FY2011 budget. Governor Schwarzenegger used a line-item veto to eliminate $133 million originally budgeted to provide mental health services for s pecial education students. County mental health departments previously used the state funding to administer programs offering crisis counseling, case management, medication management, and residential placement. The counties now allege that the governor222 s veto , coupled with the absence of a legislative override, suspends their responsibility to provide the services until the y are funded by the state . The plaintiffs are seeking a declaratory judgment stating that they do not have to provide the services until the state restores funding . Separately, m ental health advocacy groups have also sued the state, alleging that the cuts violate the Individuals with Disabilities Education Act and the Americans with Disabilities Act ( Courthouse News Services, 11/29 ). Mendocino County Eliminating 22 Mental Health Positions : To close a $2 million deficit, the Mendocino County Board of Supervisors approved the elimination of 22 mental health positions on November 9. The eliminated positions include administrative employees, social workers, client services specialists, and clinicians at the Mendocino County Health and Human Services Agency ( The Ukiah Daily Journal, 11/28 ). State Regulators Fine Insurers $10 Million for Billing Issues : Following an 18 -month investigation, on November 29, the California Department of Managed Health Care (DMHC) levied $10 million in fines against the state222s seven largest health plans. State officials say the fines stem from three years of improperly paid claims , violat ing a state law that requires health plans to pay at least 95 percent of their claims properly. In addition, state officials say that some of the plans did not have adequate systems in place to adjudicate billing disputes. Anthem Blue Cross of California and Blue Shield of California each received $900,000 fines , United Healthcare/PacifiCare was fined $800,000, Health Net Inc. and Kaiser Foundation Health Plan were each fined $750,000, Cigna Corp. was fined $450,000, and Aetna Inc. was fined $300,000 ( Los Angeles Times, 11/30 ; Kaiser Health News, 11/30 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 1, 2010 12/1/2010 3 Florida Update: State Representative Introduces New Health Care Freedom Amendment : On November 16, State Rep. Scott Plakon (R) introduced a proposed constitutional amendment ( HJR 1 ) in the Florida House that would exempt the state from the national health care reform law222s individual insurance mandate, if enacted by voters in 2012. The measure would amend the Florida constitution to declare that no rule or law may 223compel, directly or indirectly, any person, employer or health- care provider to participate in any health - care system.224 The measure is a revision of a similar amendment that the Florida Supreme Court removed from the November 2010 ballot because it contained 223misleading and ambiguous language.224 Florida Senate President Mike Haridopolos (R) says he will soon introduce a companion measure in the Florida Senate ( Health News Florida, 11/23 ). Idaho DHW Director Says 25 Percent of Residents Will be Enrolled in Medicaid by 2020 : On November 23, Idaho Department of Health and Welfare (DHW) Director Dick Armstrong testified before state legislators that approximately 25 percent of state residents will be enrolled in Medicaid by 2020. Director Armstrong also estimated that, by 2020, 15 percent of Idahoans will receive coverage through Medicare and state and federal spending will represent 50 percent of al l health care spending in Idaho. DHW officials estimate that the federal government will cover 86 percent of the cost of Medicaid enrollees made eligible under the national health care reform law before 2020 ( Idaho Reporter, 11/23 ). Illinois McHenry County MHB Approves $8.3 Million in Behavioral Health Contracts : During the week ending November 27, the McHenry County Mental Health Board (MHB) approved approximately $8.3 million in behavioral health contracts. The contracts will provide 21 organizations with funding for 80 projects and services in the county fisc al year beginning December 1. The contracts continue funding for inpatient psychiatric care for the uninsured and increase funding for peer support programs and children222s behavioral health services. Last fiscal year, McHenry C ounty financed behavioral health services for 22,400 county residents through similar contracts ( Chicago Tribune, 11/24 ). Louisiana Update: D HH Officials to Implement Medicaid Care Coordination Program in Late 2011: On November 24, Louisiana Department of Health and Hospitals (DHH) Secretary Bruce Greenstein projected that the state will begin implementing a Medicaid coordinated care plan in la te 2011. Designed to reduce Medicaid costs, s tate officials originally planned to begin implementation in April but delayed the program because of pressure over the program222 s reliance on private insurers. Secretary Greenstein says the program will likely involve care coordination by both private insurers and provider networks . State officials say the program will coordinate care for approximately 800,000 Medicaid beneficiaries, most of whom are children ( The Town Talk, 11/29 ; The Advocate, 11/26 ). Massachusetts Pediatrics Study Finds State -Funded Mental Health Consultations Improve Youth Access to Care: On November 8, Pediatrics released a study assessing the Massachusetts Child Psychiatric Access Project SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 1, 2010 12/1/2010 4 (MCPAP), a state-funded program offering free mental health consultations for pediatric primary care physicians. The study found that the program increased the proportion of pediatricians that reported meeting psychiatric patients222 needs from 8 percent to 63 percent from 2005 to 2009. In addition, the study found that t he proportion of pediatricians that reported receiving timely child psychiatric consultation s increased from 8 percent to 80 percent over the same period. The authors conclude that public health interventions that promote collaboration between pediatric primary care physicians and child mental health specialists may substantially improve access to child mental health services ( Internal Medicine News, 11/23 ). Michigan Update: City of Pontiac Wins Jury Verdict Against BCBS of Michigan Over Anticompetitive Practices : On November 16, the City of Pontiac won a $1.5 million jury verdict in a suit against Blue Cross and Blue Shield of Michigan (BCBS), alleging that the insurer222s business practices caused unfairly high costs . Under the verdict, t he city will also receive discounted rates from BCBS for several years. Eleven similar cases are pending in Michigan , in addition to suits by the U.S. Department of Justice (DOJ) and a group seeking a court order barring BCBS from engaging in alleged anticompetitive practices ( Detroit Free Press, 11/23 ; Kaiser Health News, 11/23 ). Monta na Governor Proposes $3.7 Billion Budget, Includes Coverage Expansion for Some Individuals with Mental Illnesses: Governor Brian Schweitzer (D) has proposed a $3.7 billion budget for FY2012 and FY2013 , increasing Medicaid spending and expanding coverage fo r some residents with mental illnesses. The budget would increase Medicaid spending by up to $350 million , to a total of $1 billion. Under the proposal, Montana would contribute $75 million of the new funds, or thirty percent of total Medicaid spending, while the federal government would fund the balance . The budget would also spend $17 million in mostly federal funds to expand health coverage for approximately 800 residents with mental illnesses currently covered under a state -funded program. In additi on, the budget would spend $90 million to enroll up to 20,000 additional low and middle-income children in the Healthy Montana Kids program. Enacted by voters in 2008, Healthy Montana Kids is designed to offer nearly free coverage to 30,000 children. Governor Schweitzer will meet with state legislative leaders on December 7 to address their questions about his proposal ( Billings Gazette, 11/26 ). Nebraska DBH Accepting Public Comment on 2011-2015 Behavioral Health Strategic Plan: Through December 10, t he Nebraska Department of Health and Human Services222 (DHHS) Division of Behavioral Health (DBH) is accepting public comment on its draft Strategic Plan 2011-2015 . Developed by a planning committee including DBH officials, Regional Behavioral Health Authority representatives, and the Chairpersons of the Nebraska Mental Health, Substance Abuse, and Gambling Advisory Committees, the strategic plan outlines broad measures to improve behavioral health access and quality in Nebraska . In addition, the plan proposes improving behavioral health f inancing using performance - based and recovery -oriented contracts , and increasing DBH222s capacity to conduct cost -benefit and cost- effectiveness studies. State SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 1, 2010 12/1/2010 5 officials plan to release a final report by the end of 2010 ( AP via KCAU, 11/16 ; Nebraska Behavioral Health Strategic Planning ). New York Dutchess County Committee Approves $400 Million Budget, Closes Mental Health Clinic and Cuts Methadone Program Funding : On November 23, the Dutchess County Legislature222s Budget and Finance Committee approved a $400 million budget , including behavioral health cut s for the coming fiscal ye ar . The budget would close a mental health clinic in Rhinebeck and reduce funding for a county methadone program by $20,000. The budget goes before the full county legislature on December 7 ( Daily Freeman, 11/24 ). Westchester County Recovers $61,000 in Medicaid Overpayments : On November 23, New York State officials presented Westchester County with $61 ,000 in Medicaid overpayments. Recovered u nder a joint state - local program that provides counties access to Medicaid dat a to isolate fraud and abuse, th e funds will go to the Westchester County222s share of Medicaid spending ( Mid -Hudson News Network, 11/24 ). Rhode Island Governor -Elect Planning Health Care Reform Implementation Task Force : On November 29, Governor - Elect Lincoln Chafee (I) announced that he will form a Health Care Task Force when he takes office in January. Created by executive order, t he task force will provide guidance on national health care reform implementation. Lt. Governor Elizabeth Roberts (D), who released a report in September outlining ways Rhode Island can maximize its benefit under health reform, will head the task force ( WPRI, 11/29 ). South Carolina Update: DHHS Proposes Plan to Reduce Deficit : On November 23, South Carolina Department of Health and Human Services (DHHS) officials proposed plans to reduce the department222s $228 million current -year deficit. DHHS officials propose d eliminating optional services, reducing long - term care services, and reducing provider reimbursement rates. DHHS officials say that the deficit is the result of increased Medicaid enrollment as well as federal eligibility standards and service requirements that South Carolina accepted as a condition of increased federal Medicaid funding. DHHS officials previously said that they plan to end Medicaid provider payments on March 4 if the state does not address the deficit. South Carolina222s financial oversight board will meet on December 14 to discuss ways to close the budget gap ( Southern Political Report, 11/23 ). Washington Insurance Commissioner Proposes Increased Premium Review Authority : Washington Insurance Commissioner Mike Kreidler (D) is proposing that the Washington Legislature preserve and expand his office222s authority to review health insurance rate increases. Since 2008, Washington222s Insurance Commissioner has had the authority to review premium increases in the individual insurance market but t hat authority expires after 2011. Commissioner Kreidler is requesting that state lawmakers extend premium review authority beyond 2011. In addition, Commissioner Kreidler is requesting that SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 1, 2010 12/1/2010 6 lawmakers expand the office222s authority to allow non -profit insurer surplus review s . Under the proposal , the Insurance Commissioner may deny rate increases for non-profit insurers w ith surplus es equal to or greater than three months of their claims expenses. Finally , Commissioner Kreidler wants the legislature to require insurers to disclose detailed plans for any new premium revenue ( Seattle Post Intelligencer, 11/29 ; Kaiser Health News, 11/30 ).
