WeeklyFinancingNewsPulseStateandLocalEditionfinal20091209.pdf (PDF | 301.47 kb)
SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 1 SAMHSA222s Weekly Financing News Pulse: State and Local Edition Florida Georgia Iowa Kansas Louisiana Maryland Massachusetts Minnesota Mississippi Missouri New Jersey New Mexico North Carolina Oregon Pennsylvania South Dakota Tennessee Utah Virginia West Virginia Wisconsin To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/service/multi_subscr ibe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For questions or comments, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 2 Around the States: State and Local Behavioral Health Financing News Florida Court Hears Suit Alleging Medicaid Program Fails to Meet Federal Standards for Children222s Care : A federal hearing began a class action lawsuit against the Florida Department of Children and Families (DCF), the Florida Department of Health (DOH), and the Agency for Healthcare Administration this week, alleging that Florida222s Medicaid program fails to provide sufficient care for children. The suit, initially filed four years ago, states that Florida222s Medicaid program fails to provide reasonably prompt care for children covered under Medicaid largely because too few doctors accept the insurance. The state contends that Medicaid promises only the delivery of money for care rather than actual health care services ( AP via Miami Herald, 12/6 ; New York Times, 12/7 ). Palm Beach County Restricts New Pain Clinics Due to Concern About Prescription Abuse: On December 8, the Palm Beach County Commissioners voted to place a one year moratorium on new pain management clinics in unincorporated sections of the county. The moratorium is designed to limit the number of pain clinics illegal distributing prescription painkillers. Thirty (30) pain clinics have opened in Palm Beach County since 2007 and seven are in unincorporated areas ( Palm Beach Post, 12/8 ). Fewer Caseloads Cause Hospital to End IOP Substance Abuse Treatment Program : This Fall, the Lakeland Regional Medical Center ended its intensive outpatient (IOP) substance abuse treatment program because the program no longer treated enough patients to remain lucrative. The hospital continues to offer numerous other substance abuse treatment options, including both inpatient and outpatient programs.Several other Lakelandarea substance abuse treatment facilities continue to offer IOP services and have agreed to accept Lakeland referrals ( Lakeland Ledger, 12/7 ). Leon County Survey Finds Two Thirds Want Health Reform : A survey conducted by graduate students at Florida A&M University between November 18 and November 30 found that nearly two thirds of Leon County residents believe that health care reform is necessary; however, only 36 percent support the bill ( HR 3590 ) currently before the Senate. In addition, the poll found that residents were evenly divided on the potential effects of the plan, with 32 percent believing it would improve health care and 32 percent believing it would not ( Tallahassee Democrat, 12/6 ). Georgia Governor Names William Janes as Olmstead Coordinator : Governor Sonny Perdue (R) announced that he will name William James as the Georgia Olmstead Coordinator . As the coordinator, Janes will oversee the state222s plan to improve services for residents with mental and developmental disabilities and ensure that the state complies with federal rules mandating community based care. Janes previously served as the Director of the Florida Office of Drug Control (ODC) and the Assistant Secretary of Substance Abuse and Mental Illness for Florida222s Department of Children and Families ( AP via WXIA, 12/5 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 3 Indiana Governor Says State Cannot Afford Health Care Reform222s Medicaid Expansion : On December 4, Governor Mitch Daniels (R) said that Indiana cannot afford the Medicaid expansion outlined under Senate Democrats222 national health care reform bill ( HR 3590 ). Indiana222s Medicaid program currently covers parents earning up to 26 percent of the federal poverty level (FPL) while Healthy Indiana, a state subsidized insurance program, covers some individuals earning up to 200 percent of the FPL. Under the proposed legislation, eligibility for Indiana222s Medicaid program would expand to accept all residents earning up to 133 percent of the FPL. Governor Daniels reports that, even if the federal government finances 95 percent of the estimated 500,000 new Medicaid enrollees under the Senate222s plan, the expansion would cost the state $2.3 billion over 10 years ( Journal and Courier, 12/4 ; Kaiser Health News, 12/7 ). Iowa Hospital SettlesAllegations of Overcharging Federal Health Programs : Mercy Medical CenterSioux City agreed to pay $400,000 to settle charges that the hospital overcharged Medicare and Medicaid by improperly receiving incentive payments designed for facilities taking on complicated procedures. Under the terms of the deal, Mercy admits no wrongdoing ( Becker222s Hospital Review, 12/3 ). Kansas KHPA Cuts $1.1 Million From Medicaid Administrative Budget : In addition to the 10 percent reduction in Medicaid provider reimbursements announced by Governor Mark Parkinson (D) on November 23, the Kansas Health Policy Authority (KHPA) announced December 4 that it will cut its administrative budget by $1.13 million. The cuts will reduce a staffing contract and eliminate overtime, limiting KHPA222s ability to reduce a 15,000 applicant backup. In addition, the cuts will diminish the verification process for new Medicaid enrollees and limit customer service for current enrollees by closing a call center that previously handled 250,000 customer service calls annually ( Kansas City Star, 12/5 ; Topeka Capital Journal, 12/6 ; Wichita Eagle, 12/5 ; Lawrence Journal World & News, 12/4 ; Kaiser Health News, 12/7 ). Mental Health Center Receives EHR Grant : The Tower Mental Health Foundation has awarded Central Kansas Mental Health Center (CKMHC) a $25,000 grant to update its electronic health record (EHR) system. CKMHC serves Dickinson, Ellsworth, Lincoln, Ottawa, and Saline Counties ( Salina Journal, 12/2 ). Louisiana Veterans222 Transitional Living Home Opens in Shreveport, Offers M/SU Services : On December 6, the Shreveport Volunteers of America opened a new 56bed transitional living facility for veterans, allowing veterans to live in the facility for up to one year. The facility also provides mental health treatment and substance abuse education courses to resident veterans ( ArkLaTex.com, 12/6 ). Maryland State Transfers Health Funds to Medicaid Program : As part of a budget package approved November 18 by the Maryland Board of Public Works, state officials approved the transfer of a $15 million surplus from the state222s senior prescription drug program to the state Medicaid program. The move, which was SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 4 combined with $362 million in state budget cuts, is the latest attempt to address Medicaid funding issues that have been compounded by increasing enrollment. The state is also reducing provider reimbursements, outsourcing claims processing and seeking additional federal funding ( Baltimore Business Journal, 12/4 ; Kaiser Health News, 12/7 ). Massachusetts State Eliminates 600 Mental Health Workers : Beginning December 1, the state began laying off 300 mental health workers from the Massachusetts Department of Mental Health (DMH). The layoffs along with an additional 300 DMH voluntary retirements, come as the state moves forward with the closure of West Borough Hospital to save an estimated $11 million. DMH also laid off 120 employees in January as part of a $9 million budget cut ( Gatehouse via Wicked Local, 12/1 ). Organization Awards Housing Grants to Substance Abuse Agencies : The Center for Community Recovery Innovations Inc., a non profit subsidiary of MassHousing , has awarded $295,000 in grants to create or preserve affordable housing for individuals recovering from substance abuse. The grants, which range from $35,000 to $75,000, will create or preserve 78 housing units around Boston, New Bedford, Salem, and Worcester ( Worcester Business Journal, 12/4 ). Minnesota Hospital Suspends Plans for New Behavioral Health Facility : Citing Governor Tim Pawlenty222s (R) elimination of General Assistance Medical Care (GAMC) and several other health care funding reductions, Regions Hospital has halted plans for a new $36 million behavioral health facility. The facility, which had been scheduled to openin 2013, would have included 100 new behavioral health beds and the capacity to add an additional 20 ( Minneapolis/St. Paul Business Journal, 12/4 ; KARE, 12/5 ). Mississippi Governor Cuts Budget, Medicaid Affected : On December 3, Governor Haley Barbour (R) cut Mississippi222s current year budget by $54.3 million saying that, though he has cut all he can under state law, the state continues to face a $160 million shortfall that must be addressed by the Mississippi Legislature when it convenes in January. Governor Barbour cut funding for most state agencies and programs by 5 percent, including Medicaid. However, Governor Barbour said the Medicaid funding reduction will not take effect until February 2010 to allow Medicaid providers to prepare for reduced reimbursements. The governor did not provide details on the reimbursement reductions but he did note that the Medicaid cuts will not affect the state222s Medicaid service offerings ( ClarionLedger, 12/4 ; Kaiser Health News, 12/7 ). Missouri Missouri Delays 223Express Lane Eligibility224 Over Funding Issues: An Associated Press investigation revealed that the Missouri Department of Social Services recommended enacting six measures to implement 223express lane eligibility224 after President Obama authorized the program under the Children222s Health Insurance Program Reauthorization Act (CHIPRA) earlier this year. The express lane eligibility measures would have allowed the state to enroll children in Medicaid and the Children222s SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 5 Health Insurance Program (CHIP) based on their enrollment in other federal aid programs; however, those measures were slated to cost $47 million and were delayed numerous times because of funding constraints. State officials now say that they are unlikely to implement express lane eligibility during FY2010 ( AP via Belleville News Democrat, 12/6 ; Kaiser Health News, 12/7 ). State Legislators Pre File Autism Coverage Bill : Governor Jay Nixon (D) and several Missouri legislators are touring the state to promote bills already pre filed in both houses of the Missouri Legislature designed to expand coverage for Autism Spectrum Disorders (ASD). Under the proposed bills, insurance companies may not limit the number of therapy sessions provided to children with ASDs nor may they restrict, terminate, or refuse to renew up to $72,000 worth of coverage based on an ASD diagnosis ( KSMU, 12/3 ). New Jersey State Senate Passes Medical Marijuana Bill : The New Jersey Senate passed a bill that would allow people with certain debilitating conditions to posses, grow, and use marijuana after a physician determines that it would be medically useful. The Senate222s bill specifically lists AIDS, cancer, and glaucoma asillnesses to be covered under the medical marijuana proposal; however, senators say that the list is not finalized. The New Jersey Assembly is expected to pass companion legislation shortly and Governor Jon Corzine (D) has said he would sign a medical marijuana bill if the legislature passes one before he leaves office. Governor Elect Chris Christie (R) indicated that he supports the legislation but has not officially endorsed it, citing insufficient restrictions in one draft bill ( Wall Street Journal, 12/1 ; Join Together, 12/4 ). New Mexico Study Finds Alcohol Abuse Costs New Mexico $2.5 Billion Annually: A study released by the New Mexico Department of Health found that the economic costs of alcohol abuse in New Mexico totaled $2.5 billion in 2006. The study also notes that the cost was 27 times greater than the $97 million in state tax revenue collected on alcohol sales ( Join Together, 12/2 ). Update: OptumHealth to Contest Collaborative222s Fine: OptumHealth New Mexico has announced plans to contest fines imposed on the company by the New Mexico Behavioral Health Collaborative for failure to pay behavioral health care providers in a timely manner. In late October, the collaborative fined OptumHealth $1.2 million and, at a meeting on November 10, fined OptumHealth again, imposing a $10,000 per day sanction until the contractor pays all overdue claims. The collaborative will hold a meeting on OptumHealth222s challenge on January 7 ( New Mexico Independent, 12/3 ). North Carolina Update: Audit Finds Albemarle Mental Health Center Was in Debt Prior to State Takeover : An audit for fiscal year 2007 8 revealed that, before the state assumed control of the Albemarle Mental Health Center (AMHC) in July, AMHC was already $2 million in debt. According to the audit, the 10county agency was using retirement funds to supplement its general fund and paying unrelated bills with SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 6 Medicaid reimbursement funds. Auditors say there was no indication of theft or corruption ( Virginian Pilot, 12/6 ). Oregon Update: State to Receive $699,000 from Aventis Medicaid Settlement : The Oregon Attorney General announced that the state will receive $699,106 from a U.S Department of Justice (DOJ) settlement reached with Aventis Pharmaceutical Inc. in May. The $95.5 million deal settled charges that Aventis did not offer state Medicaid programs fair drug prices between 1995 and 2000. Oregon222s share of the settlement comes from the roughly $40 million which will be distributed to various states to compensate them for their share of Medicaid drug costs ( Oregonian, 12/1 ). Pennsylvania House Committee Holds Hearing on Medical Marijuana Bill : On December 5, the Pennsylvania House Committee on Health and Human Services (HHS) held a hearing on HB 1393 , which would allow patients with HIV/AIDS, cancer, and certain other illnesses to obtain and possess medical marijuana. Under the bill, which was introduced by State Rep. Mark Cohen (D), patients could posses up to one ounce of marijuana and six marijuana plants. The bill would also create state licensed dispensaries to sell the product to medically approved patients. HHS Committee Chair Frank Oliver (D) plans to hold more public hearings before scheduling a committee vote ( Newslanc, 12/5 ; PatriotNews via Penn Live, 12/3) . Bradford County Releases Budget, State Funding Affects Mental Health Services : On December 3, the Bradford County Commissioners released the county222s $56.2 million 2010 budget, reducing spending by over $1 million from the county222s 2009 budget. One of the largest cuts came from a $319,000 reduction in state payments for county human services, including a $145,698 cut to mental health services ( Morning Times, 12/4 ). Camden Behavioral Health Facility Expands: Genesis Counseling Centers is expanding its Camden operations by relocating to a new facility that will be twice the size of its current one. The new facility, which is scheduled for completion in March 2010, will allow Genesis222 Camden location to offer mental health services not previously available and see 500 additional clients annually ( CourierPost, 12/7 ). South Dakota Governor Proposes Budget, Freezes Medicaid Reimbursements: On December 8, Governor Mike Rounds (R) proposed a $4 billion state budget, increasing state general fund spending by $52 million over the previous year. Nearly all of the increased state funding will fund coverage for new Medicaid enrollees as the number of eligible residents has increased by 9,000 over two years. Though Governor Rounds222 budget directs more state funds to Medicaid, provider reimbursements will remain frozen at 2009 levels ( Yankton Press & Dakotan, 12/8 ). Tennessee Update: State Caps Enrollment in CoverKids: After announcing the move in October, Tennessee stopped accepting new applicants for its CHIP, CoverKids, on December 1. The move will not affect any SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 7 of the programs 43,735 current enrollees and is due to a projected $1.5 billion budget shortfall. Tennessee is the only state to freeze CHIP enrollment and the Tennessee Legislature plans to reexamine the CHIP freeze and the state222s CoverTN enrollment freeze when the legislativesession begins in January ( Tennessean, 12/2 ; Kaiser Health News, 12/2 ). Utah State Legislator Proposes Bills to Strengthen Prescription Drug Monitoring, Combat Abuse : State Rep. Brad Daw (R) has put forward four bills for the Utah Legislature222s upcoming session that would strengthen the state222s prescription drug monitoring program (PDMP). One of Rep. Daw222s bills would require hospitals to report prescription drug overdoses to the state222s PDMP, the Division of Occupational and Professional Licensing222s database, while another bill would require the police to submit data on convictions for prescription impaired driving. In addition, State Rep. Trisha Beck (D) has proposed a bill clarifying existing language in the state222s four main prescription drug laws ( Desert News, 12/5 ; Utah Legislature ). Virginia Governor Instructs Staff to Begin Extending State Employee Health Benefits to Same Sex Partners : Governor Tim Kaine (D) ordered the Virginia Department of Human Resource Management (DHRM) to begin implementing a proposal to offer health benefits to samesex partners of Virginia employees under the state222s employee benefit plan. A DHRM spokesperson said that they expect that the move will not cost the state because employees222 partners would be required to pay the full cost of their coverage. However, the DHRM spokesperson also noted that full implementation of the proposal would extend well past the January 16 end of Governor Kaine222s term, leaving the decision to continue the proposal to Governor Elect Bob McDonnell (R) ( Washington Post, 12/4 ). West Virginia Actuarial Report Finds Medicaid Expansion Could Save State $2.2 Billion Annually : A report prepared by CCRC Actuaries found that expanding Medicaid to cover all residents earning up to 100 percent of the FPL could save the West Virginia up to $2.2 billion annually when coupled with an individual and employer health care mandate. The study also found that expanding Medicaid without an employer mandate would save the state roughly $1.6 billion annually and estimated that any expansion would cost the state between $40 and $50 million annually after the state assumes its share of the costs for the new enrollees. West Virginia222s Medicaid program currently covers families with incomes up to 35 percent of the FPL ( Charleston Gazette, 12/7 ). Wisconsin Advocates Claim BadgerCare Plus Core Plan Violates Federal Parity Law: Behavioral health advocates claim that Wisconsin222s Medicaid waiver program, the BadgerCare Plus Core plan, violates the Wellstone Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) set to take effect in January 2010. The core plan, which began this year, offers parity for psychiatrist visits and for medication but does not cover counselors, psychologists, therapists, social workers, addiction experts, or inpatient hospitalization. A Wisconsin Department of Health Services (DHS) spokesperson said that SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 9, 2009 12/9/09 8 the department believes the program complies with the law because MHPAEA requires only that offered services be equal to general health care and does not mandate that plans offer a full range of mental health and substance abuse services. DHS says they expect the Centers for Medicare & Medicaid Services (CMS) to issue guidelines on the issue in January ( Cap Times, 12/6 ). Legislators Introduce Medical Marijuana Bills : Members of the Wisconsin Legislature recently introduced bills in the House and Senate that would legalize the possession of medical marijuana for individuals with AIDS, cancer, and certain other illnesses.Under the proposed laws, individuals with the pre determined illnesses and approval from a doctor could obtain a state registration card and procure marijuana from a state licensed facility. The bills would allow medical marijuana users to posses up to six marijuana plants or three ounces of the drug ( Wausau Daily Herald, 11/27 ; Join Together, 12/1 ).
