State Issues Medicaid Budget Summary
The Pennsylvania Department of Public Welfare’s Office of Medical Assistance Programs has released a summary and overview of its recently passed FY 2014 Medicaid budget.
Find the overview document here
.
MAAC Meets
The Medical Assistance Advisory Committee that works with the Pennsylvania’s Department of Public Welfare met recently in Harrisburg.
Among the subjects discussed during the meeting were the state’s recently passed budget, the Medical Assistance program, the prospects for Medicaid expansion, and more.
Read the official state file note summarizing the meeting here
.
DPW Seeks to Renew Philadelphia Assessment
The Pennsylvania Department of Public Welfare has announced its intention to seek renewal of the Philadelphia hospital assessment first authorized in 2008.
The purpose of the assessment is to generate additional revenue to fund state Medicaid expenditures for hospital outpatient and emergency department services in Philadelphia and to provide additional funding to support the city’s public health clinics.
Read the Pennsylvania Bulletin announcement of DPW’s intention here
.
Budget Bill Proposed in PA House
The chairman of the Pennsylvania House Appropriations Committee has introduced a bill proposing a budget for the state’s 2014 fiscal year.
House Bill 1437, sponsored by Rep. Bill Adolph (R-Delaware), calls for $100 million less spending than the $28.4 billion budget proposed by Governor Tom Corbett in February.
The bill also includes a number of differences in proposed spending for Medicaid and Department of Health programs.
For a summary of the bill, with an emphasis on provisions with the greatest interest to Pennsylvania’s safety-net hospitals, please hit the “contact us” link at the top of this screen.
State Budget
DPW Says Fiscal Office Understates Cost of Medicaid Expansion
The Pennsylvania Department of Public Welfare has released a letter it sent to the state’s Independent Fiscal Office (IFO) rejecting many of the assumptions underlying the latter’s analysis of the cost of expanding Medicaid eligibility in the state and stating that as a result of these incorrect assumptions, the IFO has significantly understated the cost of Medicaid expansion in Pennsylvania.
According to the letter sent by acting DPW secretary Beverly Mackereth to IFO director Matthew Knittel, the IFO inaccurately characterizes the baseline year during which to account for potential costs and savings; incorrectly maintains that upfront costs – including hiring 2000 new workers at higher salaries than the IFO projects – will be less than savings; and overstates savings associated with increased federal matching funds for General Assistance recipients.
DPW also maintains in the letter that the IFO incorrectly assumes that new enrollment will take place gradually instead of fairly quickly once expansion begins; underestimates the number of new “woodwork” enrollees – individuals already eligible for Medicaid who will enroll in the program because of all the attention the eligibility expansion will receive; and prematurely assumes continued income from the gross receipts tax on Medicaid managed care organizations before the federal government has had an opportunity to decide whether the state will be permitted to continue levying that tax.
Read about the letter in this Philadelphia Business Journal article or download the letter itself here.
New DPW Secretary Testifies Before Senate
Acting Department of Public Welfare Secretary Beverly Mackereth appeared before the Senate Appropriations Committee this week for the first time to present and defend her department’s proposed FY 2014 – including its Medicaid budget.
Mackereth, herself a former member of the state House, also responded to committee members who questioned Governor Corbett’s decision not to expand Medicaid eligibility in the state, as provided for in the federal Affordable Care Act.
She also promised more dialogue with the General Assembly in the future.
Read more about Ms. Mackereth’s budget testimony before the Senate Appropriations Committee in this Allentown Morning Call article
State Budget
.
The Proposed FY 2014 State Budget: Part 7 of 7
Department of Health
Pennsylvania Governor Tom Corbett recently unveiled his proposed state FY 2014 budget. The day he did, members of the Safety-Net Association of Pennsylvania (SNAP) immediately received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP has presented in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. In this final installment, SNAP takes a look at what that budget proposes for the state’s Department of Health.
The Department of Health’s budget calls for a number of spending cuts. Among them, it calls for the complete elimination of funding associated with its diabetes, poison control centers, Tourette Syndrome, epilepsy support services, lupus, trauma coordination, ALS support services, and biotech research programs. Together, this accounts for a $6.3 million cut in Health Department funding.
On the other hand, the department’s proposed budget includes $4 million in grants to clinics to improve access to primary care in medically underserved areas and $1 million in new money to support 24 additional loan repayment grants to enhance the recruitment of doctors to medically underserved areas.
The Proposed FY 2014 State Budget: Part 6 of 7
The Children’s Health Insurance Program
Pennsylvania Governor Tom Corbett recently unveiled his proposed state FY 2014 budget. The day he did, members of the Safety-Net Association of Pennsylvania (SNAP) immediately received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about the Children’s Health Insurance Program.
The governor’s proposed FY 2014 budget includes $24 million in new money for the Children’s Health Insurance Program (CHIP). This additional funding will support the addition of more than 9300 children to the program.
Tomorrow: Department of Health
The Proposed FY 2014 State Budget: Part 5 of 7
Other Medical Assistance Issues
Pennsylvania Governor Tom Corbett recently unveiled his proposed state FY 2014 budget. When he did, members of the Safety-Net Association of Pennsylvania (SNAP) immediately received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about Medical Assistance issues not addressed in parts one through four of this series.
The proposed budget calls for a number of other changes in Medical Assistance spending, including:
- New spending of $55.9 million in total funds for what has been labeled a “public-private collaboration project” under the outpatient budget that is offset by a $28.5 million savings within the same budget line.
- Savings in the inpatient, outpatient, and capitation (managed care/HealthChoices) budget lines associated with “audit enhancements.”
- Savings associated with the state outsourcing its third-party liability functions, including payment recovery.
- A doubling of state spending on information technology to bring Pennsylvania’s Medical Assistance eligibility systems and technology up to the requirements of the Affordable Care Act.
- An increase of $27 million for mental health services and $3.2 million for state mental health services block grant funding
- A savings of more than $8 million associated with instituting premiums for so-called loophole children who participate in the state’s PH-95 program for selected Pennsylvanians with autism.
Tomorrow: The Children’s Health Insurance Program (CHIP)
The Proposed FY 2014 State Budget: Part 4 of 7
Medical Assistance Supplemental Payments
Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about Medical Assistance supplemental payments.
Governor Corbett has proposed no change in the state’s spending on OB/NICU, burn center, and trauma center payments. Because of the reduction in the state’s federal medical assistance percentage (FMAP, or the rate at which the federal government matches state Medicaid spending), total payments to hospitals in each of these programs stands to decline 1.7 percent.
The total amount available for tobacco uncompensated care payments is slated for a 3.3 percent decrease, from $56.5 million to $54.7 million. This reflects two factors: a 1.7 percent decrease in money available from the tobacco settlement fund and the state’s reduced FMAP rate.
While total funding for physician practice plans is slated for an 18.9 percent decrease, this appears to reflect a decision to remove from this category one hospital that was added to the group last year. This would mean funding for physician practice plans would remain the same – as it would for academic medical center disproportionate share hospital payments (DSH).
Critical access hospital payments have been targeted for a $500,000 cut in state funds.
Inpatient DSH, outpatient DSH, medical education, and Community Access Fund payments do not have their own line-items in the proposed budget and therefore cannot be specifically identified in that budget. Traditionally, however, when an administration is contemplating changes in these payments, it indicates so in the programmatic revision commentary section of the budget document. In the case of these four payments that are so vital to so many Pennsylvania safety-net hospitals, they were not mentioned in the programmatic revision commentary.
Next Monday: Other Medical Assistance Issues