SAMHSA222s Weekly Financing News Pulse: State and Local Edition
March 9, 2011 3/9/2011
1
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
Arkansas California C
olorado Florida Georgia I
ndiana Iowa Kansas Kentucky
Louisiana M
aine M
aryland Montana New York North
Carolina South Carolina Wisconsin
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SAMHSA222s Weekly Financing News Pulse: State and Local Edition
March 9, 2011 3/9/2011
2
Around the States: State and Local Behavioral Health
Financing New
s Arkansas
House Committee Approves PDMP Bill
: On March 3, the Arkansas House Public Health, Welfare and
Labor Committee
approved legislation (
SB 345) to establish a prescription drug monitoring program
(PDMP) in Ar
kansas. The
Arkansas Senate approved the bill on March 2. The bill would establish a
statewide database of controlled substance
prescriptions
, which would be available to
law enforcement.
The bill now goes before the full Arkansas House
( NECN, 3/2 ).
California
Update: Conference Committee Approves Budget Cutting Medicaid Funding
: On
March 3
, a
California
Legislature
conference committee
approved an FY2012 budget that would cut
Medicaid and mental
health funding.
The committee222s budget includes a 10 percent reduction in Medicaid reimbursements
for most services, designed to save the state approximate
ly $700 million.
In addition, rather
than
Governor Jerry Brown222s
(D) proposed
223hard224 cap of 10 monthly doctor visits
per Medicaid beneficiary
,
the committee agreed to
a 223soft224 cap of seven visits, with exceptions allowed
when
medically necessary
.
The bud
get would also implement Medicaid copayments to save approximately $550 million.
Finally
,
t
he budget would cut general fund
s for
mental health programs
by $861 million, replacing
that funding
with
Proposition 63
funding
and providing
counties an additiona
l $28 million in
Prop.
63
funds. The
budget now goes before the California Assembly
and
Senate
( California Healthline, 3/4 ; California Healthline, 3/4 ; AP via the San Diego Union-Tribune, 3/3 ).
Judge Orders Injunction on Medicaid Inpatient Hospital Rate Freeze
: On March 4,
U.S. District Court
Judge Frank C. Damrell Jr.
placed an injunction on a planned Medicaid inpatient
hospital reimbursement
rate freeze
.
The
California Hospital Association
filed a motion requesting the
injunction
in its suit
challenging the legality of the freeze.
Approved by the California Legislature
in October, the freeze was
scheduled to take effect February 1
, locking
reimbursemen
ts at the lesser of rates paid on either January
1, 2010 or July 1, 2010. Judge Damrell Jr. placed
an injunction on the freeze until the suit is completed
or the parties reach
an
agreement ( The Sacramento Bee, 3/5 ).
Update: Blue Shield Consultant Finds Rate Increases Reasonable
: On March 8, Axene Health Partners
released a report
concluding that
Blue Shield of California222s proposed
individual health insurance
premium increases are reasonable
. Axene Health Partners222 report
determined
that the rate increases
,
which average 6.5 percent and are as high as 18 percent, are
justified in light of rising health costs. The
report recommends that state officials accept the increase
s
. After initially refusing to delay the
increases,
Blue Shield officials agreed to a 60 day delay to
allow
California Insurance Commissioner
Dave
Jones
(D) adequate time to determine whether they
meet the state222s 80 percent medical loss ratio
(MLR) requirement for the individual market ( Los Angeles Times, 3/1 ; Kaiser Health News, 3/1 ).
Colorado
Senate Committee Votes Against Renewing PDMP
: On February 25, the Colorado Senate
Appropriations Committee
voted not
to
renew
the state222s prescription drug monitoring program
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
March 9, 2011 3/9/2011
3
(PDMP)
. Funded through federal grants and health care provider license fees, the program costs
approximately $270,000 annually. Lawmakers supportive of the PDMP say they are drafting legislation
to p
reserve the program ( The Denver Post, 3/7 ).
Florida
DOH Presents Legislature with Reorganization Plan
Ending
State Funding for
County
-Level Primary
Care
: As required by the Florida Legislature,
on
March 2
the
Florida Department of Health
(DOH)
presented a plan to reorganize the department
and cut costs
. The plan would eliminate 1,600 positions,
consolidate operations within DOH, and
save
$22.3 million by ending primary care payments to county
heal
th departments. In addition, the plan would require contracting with a private firm to run at least
part of
the state222s Children222s Medical Services
agency
, which serves children with serious medical
conditions. The legislature will review the plan as it
negotiates a budget for the upcoming fiscal year
( Health News Florida, 3/2 ; Kaiser Health News, 3/2 ).
Georgia
Bristol-
Myers Squibb Foundation and CSX Corporation Financing Mental Health Pilot
: The
Bristol-
Myers Squibb Foundation
and
CSX Corporation
are financing a two
-year pilot program to coordinate
mental health services for 100 individuals in southeastern Georgia. Operated by the Georgia
Department of Behavioral Health and Developmental Disabilities
(DBHDD), the
Emory School of
Medicine
, and the National Alliance on Mental Illness
(NAMI),
the pilot program will provide case
management to individuals cycling through treatment institutions, homelessness, and the criminal
justice system
. The program will also provide mental health training for
law enforcement
officers ( The Augusta Chronicle, 3/7 ).
Indiana
Purdue Implementing Alcohol Education Course for Incoming Students
: Beginning in the 2011 fall
semester,
Purdue University
will implement an alcohol
education course for incoming students. Under
the program, b
etween July 15 and August 20, freshmen and transfer students
must
take an online
course on the safe use of alcohol. University officials say the program is designed to reduce misuse of
alcohol
among students and will cost $22,800 ( The Purdue Exponent, 3/7 ).
Iowa
Senate Considering Bills Establishing Health Insurance Exchange
: The
Iowa Senate is currently
considering two bills to establish a health insurance exchange in Iowa, as required by the national health
care reform law.
On March 1, t
he
Iowa Senate Judiciary Committee approved a bill (SF 348)
that
would
establish an
exchange, with no requirements on who may
sell
health plans. That bill now goes before
the full Senate
.
A second
bill (
SF 235), still under consideration in committee,
would
establish an
exchange but
allow
only licensed insurance agents to sell policies within it
, receiving commissions for
the policies
they sell ( The Des Moines Regist
er, 3/7 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
March 9, 2011 3/9/2011
4
Kansas
Insurance Department Finds Three of Five Large
Health Insurers Meeting MLR Requirements
: The
Kansas Insurance Department
has found that three of the state222s five largest health insurers,
representing nearly 70 percent of the state222s individual and small group markets, meet the national
health care reform law222s medical loss ratio (MLR) requirements. Health reform requires most
insurers to
meet MLRs of at least 80 percent
and large insurers to meet MLRs of 85 percent. Insurers that do not
meet MLR requirements must pay rebates to consumers. Examining 2009 data, the department found
that
American Medical Security
,
Blue Cross Blue Shield of Kansas
,
and
Blue Cross Blue Shield of Kansas
City
had MLRs above 85 percent. Coventry Health and Lif
e
and
Time Insurance Company had MLRs
below 80 percent ( Kansas Health Institute, 3/4 ; Kaiser Health News, 3/7 ).
Kentucky
Update:
Senate Approves Measure Balancing Medicaid Budget: On March 2, the Kentucky Senate
approved legislation designed to balance the state222s Medicaid budget
, relying on
$22.4
million
from
a
projected surplus. The measure would
also
make spending cuts of 0.5 percent in the current fiscal year
and 2.3 percent in the fiscal year beginning July 1. The Senate must negotiate
with the
Kentucky House
,
which passed its own measure (
HB
305
)
balancing the Medicaid budget. The House measure
would
cover current
-year Medicaid costs with
$166.5 million originally allocated for 2012 and would
achieve
further
savings through
the
expanded use of privately contracted Medicaid services ( Lexington Herald- Leader, 3/3 ).
Louisiana
Governor Uses Executive Order to Establish Coordinated Youth Behavioral Health Care
System
:
Using
an executive order,
on March 3
Governor Bobby Jindal
(R)
established
a coordinated care system
serving
youth with behavioral health needs. The Louisiana Office of Juvenile Justice
(OJJ) and Louisiana
Departments of Children and Family Services
(DCFS),
Education, and
Health and Hospit
als
(DHH) will
participate in the system.
State officials say the program will serve
2,400
youths
by
June 30, 2012
and
ultimately
coordinate behavioral health services for 42,000 youths. Governor Jindal says that
,
once
Louisiana
receives a state plan ame
ndment waiver from the Centers for Medicare & Medicaid Services
(CMS)
,
the new system will save the state $16.3 million through FY2013. State officials say the system is
designed
to reduce out
-of
-home placement, reduce state costs, and improve health outcomes ( KATC, 3/3 ; The Advocate, 3/4 ).
Maine
U.S. District Court Judge Rules State Must Rep
ay
Federal Government
$29.7 Million for Improper
Medicaid Funding
: On February 25, U.S. District Court Judge John Woodcock
ruled that Maine must
repay the federal government $29.7 million for improperly
seeking and receiving Medicaid
reimbursements in 2002 and 2003. Ruling on a previous administrative decision
,
Judge Woodcock found
that the
Maine Department of Health and Human Services
(DHHS)
improperly
used the payments for
administrative functions not
directly related to Medicaid ( Bangor Daily News, 2/28 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
March 9, 2011 3/9/2011
5
Maryland
Legislature Considering Single-Payer Health Plan
: The
Maryland Legislature
is currently considering
legislation that would establish a single
-
payer health system in Maryland. The bills would establish a
single-payer
health
system,
guaranteeing
coverage to all state residents. The
Maryland House
bill (
HB
1035) is curr
ently before the Maryland House Health and Government Operations Committee
and the
Maryland Senate
bill (
SB 388) is currently before the Maryland Senate Finance Committee
( Los Angeles Times, 3/3 ).
Montana
Update:
Legislative Committee Cuts $
129
Million From Governor222s Health and Human Services Budget
:
On March 3, the Montana
House Appropriations Committee
made $
129
million in
health and human
services
cuts to
Governor Brian Schweitzer222s
(D) proposed
$3.7 billion
biennial budget. The committee
eliminated Governor Schweitzer222s planned
tobacco prevention funding
and modified the governor222s
budget to remove
7,000 individuals from
the Big Sky Rx prescription drug program, which provides
prescription drugs to approximately 11,000 Montanans.
The
budget now goes
before the full Montana
House
( KPAX, 3/4 ).
New Yo
rk
Cornell University Allocates $1 Million in Additional Mental Health Funding
: Citing increased demand,
Cornell University
officials have agreed to allocate $1 million in additional funding for student mental
health services over three years. Beginning this fall, the
university will use the
funds
to hire
five
therapists and one nurse practitioner. University officials say they plan to increase individual and group
counseling offerings and provide students with medication management ( The Cornell Daily Sun, 3/1 ).
North Carolina
Update: Governor Vetoes Bill Barring Individual Insurance Mandate
: On March 5, Governor Beverly
Perdue
(
D) vetoed legislation (
HB 2
) that would bar any law requiring an individual to obtain health
insurance or interfering with an individual222s right to pay for health services directly. The bill would have
also
required
Attorney General Roy Cooper
(D) to
cont
est
the national health care reform law in court.
Designed to challenge the national health care reform law222s individual insurance mandate, the bill would
have been symbolic because federal law would have superseded it. State lawmakers could override the
veto with a three
-fifths majority in the
North
Carolina
Legislature
( WRAL, 3/5 ).
South Carolina
DHHS Planning 3 Percent Medicaid Reimbursement Cuts
:
Beginning
April 4, the South Caro
lina
Department of Health and Human Services
(DHHS)
plans
to implement 3 percent Medicaid provider
reimbursement reductions. Dependent upon passage of a bill (
S 434) authorizing DHHS to reduce
Medicaid provider rates, the cuts would last through the end o
f the current fiscal year on June 30. State
officials say the cut
s
would save $7.5 million and
contribute to closing the state222s $125 million Medicaid
deficit ( Becker222s Hospital Review, 3/7 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
March 9, 2011 3/9/2011
6
Wisconsin
Governor Proposes Budget
Cutting
Health Spending
: On March 1, Governor Scott Walker (R) proposed
a two
-year $59 billion budget for the biennium beginning July 1. The
budget would reduce
spending by
$4.2 billion, or 6.7 percent
,
and cut Medicaid spending by $500 million over two years.
Governor
Walker222s budget would also
require the state to request federal approval to narrow
Medicaid eligibility
requirements. If the state
does
not receive federal approval, the budget would require
Wisconsin
to
end Medicaid coverage for families earning over 133 percent of the federal poverty level (FPL).
Wisconsin currently covers families earning up to 200 percent of the FPL. The
budget
would also
convert
the Wisconsin Resource Center into a 45
-bed mental health facility to serve female state
inmates, as required by a
U.S. Department of Justice
(DOJ) settlement. The budget now goes before the
Wisconsin Legislature
( Kaiser Health News, 3/2 ; The Wall Street Journal, 3/2 ; Appleton Post Crescent, 3/6 ; USA Today, 3/2 ; Milwaukee Journal Sentinel, 3/1 ).
