States grapple with new ways to cut state Medicaid costs

Among the strategies being used are efforts to change rules, revise definitions, tighten anti-fraud efforts and cut services.

The New York Times: 49 Suggestions For Cutting Billions In State's Medicaid Costs
Personal shopping and cleaning services for the disabled would be eliminated, weak hospitals could be merged and brand-name drugs would be limited under a series of budget-cutting proposals announced on Tuesday by the New York State Health Department (Hartocollis, 2/15).

Health News Florida: Medicaid 2011: HMOs Rule
Senate leaders began rolling out a plan to transform the Medicaid system Tuesday with a threat: If Washington doesn't go along, Florida could give up billions of dollars in federal money and run the program itself. The plan, outlined during a special meeting in the Senate chambers, would shift hundreds of thousands of low-income Floridians into private managed-care plans. It would exempt certain people with disabilities, while also placing tough requirements on HMOs and shielding doctors from malpractice lawsuits when they treat Medicaid patients. ... But at least for now, the chances of the federal government giving such flexibility to Florida appear slim. The state already is in limbo because the federal government has raised questions and sought changes in a much more modest Medicaid pilot program that covers five counties (Saunders, 2/15).

Connecticut Mirror: Malloy's Budget Cuts Could Hinge On His Definition Of The 'Safety Net'
[W]hen [Gov. Dannel P.] Malloy unveils his plan Wednesday to close a $3 billion-plus shortfall for the coming fiscal year with nearly $2 billion in cuts, the governor's definition of Connecticut's social service and health care "safety net" may not match those of others. Is it limited simply to Medicaid, a $4 billion component of this year's $19.01 billion budget, which provides funding for nursing home and other long-term care and health services for poor families, childless adults on welfare, the aged, blind and disabled? ... What about the $83 million Connecticut will send to its acute care hospitals this fiscal year to help them meet their mandate of treating all emergency room patients regardless of their ability to pay? (Phaneuf and Becker, 2/15).

The New York Times: Connecticut Governor, Tackling Budget, Criticizes Christie's Approach
Mr. Malloy grew up with dyslexia and physical disabilities. He still cannot write or type. And as he closes a 20 percent budget deficit, he spends much of his energy finding ways to spare the most vulnerable. But what is most striking about Mr. Malloy, a Democrat, is that just six weeks after taking charge of such a mild-mannered state, he is publicly taking shots at his celebrated counterpart in New Jersey, attacking his politics and policies, his intellect, even his personality (Halbfinger, 2/15).

The Texas Tribune: Medicaid Fraud Up? Or Is State Getting More Vigilant?
The quickest way to cut the state's reeling Medicaid costs? Eliminating fraud and recovering funds, state officials said at a morning hearing. "I just don't think people out there have any idea how much money is being scammed," said Sen. Jane Nelson, R-Grapevine, who has filed a bill to reduce Medicaid fraud and reform how payments are made. ... David Morales, deputy first assistant to the attorney general, told the committee that fraud takes many forms, from billing for services not provided, to up-coding. He said some providers have even billed for diluted or Mexican pharmaceuticals. ... Morales says the Legislature's expansion of the attorney general's Medicaid fraud unit has helped bring in more cases. Since 2003, when the number of lawyers working these cases increased from five to 30, the number of open criminal cases has increased from 165 to 815, and convictions have increased from 68 to 337. "We're recovering tremendous amounts of money," he said (Aaronson, 2/15).

Minnesota Public Radio: Advocates Say Disabled, Seniors Unfairly Targeted In Budget
Long-term care providers say Gov. Mark Dayton's budget unfairly targets seniors to balance the state's projected $6.2 billion shortfall. The governor proposes raising the Medical Assistance surcharge for nursing homes by $635 per bed. Dayton says nursing homes would be able to recoup those taxes through higher reimbursement payments that will flow in from the federal government. ... The governor is also proposing a 2 percent across-the-board cut to nursing facilities, and a 4.5 percent cut to home and community-based services (Benson, 2/16).