Medicaid program

> A new report says that North Carolina is so behind in providing mental health services that it will need more than $500 million for the next five years to meet its obligations. Article

> The Cleveland Clinic is sinking $163 million into its Hillcrest Hospital campus expansion over the next five years, the most it's ever spent on one of its nine community hospitals. …

After years of going it on its own, Tennessee has gotten back its share of Disproportionate Share Hospital payments, at least for fiscal 2007. The state will get $131 million, which will be distributed to hospitals that treat a particularly high percentage of poor and uninsured patients. The state had given up these funds in the early 90s when it created its expanded Medicaid program, TennCare. However, since the state cut back TennCare, it has been lobbying to get the funds back. …

A Connecticut court has ruled that under Freedom of Information rules, the HMOs running the state's Medicaid program must disclose the rates that they pay cardiologists and gastroenterologists. They're also being required to disclose the number of times patients were denied prescriptions due to lack of prior approval, and whether those patients were given temporary supplies. The FOI case, which was originally brought by Yale professor Kari Hartwig and the New Haven Legal Assistance …

A new report released by the state of Connecticut suggests that the state's hospitals are in a uniquely difficult financial position. The report, issued by the state's Legislative Program Review and Investigations Committee, concluded that Connecticut hospitals "appear not as healthy financially as hospitals in the rest of the country." This is music to the ears of the Connecticut Hospital Association, which has been making this point for more than a decade, according a piece in the …

Both Democrats and Republican in the National Governor's Association are opposing the Bush Administration's planned cuts to Medicaid payments. As part of the 2007 budget, the cuts would reduce the rate that states tax nursing homes and hospitals from six percent to three percent. The White House says the changes are necessary in order to preserve the program. HHS Secretary Mike Leavitt added …

Kentucky is the first state to redesign its Medicaid program under new procedures greenlighted by the Deficit Reduction Act of 2005, which says states can overhaul their benefit packages without getting an advance waiver from CMS. This analysis from the Heartland Institute, a think tank that promotes free-market solutions for just about everything, takes a look at the strategy, called KyHealth Choices. Article

Universal healthcare seems to be back in vogue, with two Congressmen proposing new healthcare bills designed to increase access to affordable care. Rep. Pete Stark (D-CA) is pitching a program which will be based on the Medicare model. Documents provided by the congressman's office say that the plan will be financed by "using the administrative efficiencies within Medicare and building on the existing coverage people receive through their jobs today." AmeriCare, as it is called, …

Colorado's largest Medicaid managed-care plan, Colorado Access, won't renew a Medicaid contract that expires August 31. The plan covers medical care for 65,000 low-income enrollees. The decision was made after the state told Colorado Access it was facing a 15 percent drop--about $1.2 million per month--in its reimbursement. "We could not in good conscience ask providers, who are already underpaid, to take a 15 percent decrease," said CEO Don Hall in an interview with The Denver …

A new study from the Mayo Clinic reports that intensive care accounts for 30 to 40 percent of hospital spending, with the majority of care given to elderly patients with chronic conditions. In Olmsted County, NY, where the Mayo Clinic is based, patients in the last year of life accounted for one of every four days spent in the ICU. Treatment in this expensive setting contributes to the overall rise in healthcare costs. In another recent conducted study by the Center for the Evaluative …

Medical groups in Illinois say they are worried that the state's new universal coverage program for kids will encounter the kind of problems its Medicaid program has run into in recent years. Gov. Rod Blagojovich (D) is selling the All Kids program, which goes into effect July 1, as a way for the state to make sure that kids in families without insurance have access to healthcare services. The Illinois Medical Association says many physicians may not participate in the program. The state …