States wrestle with Medicaid funding and budgets, contracts, rule changes

News outlets report on Medicaid developments in Kentucky, Colorado, Arizona and Hawaii.

Lexington Herald-Leader: Beshear Administration Delays Release Of Details On Medicaid Contracts
Gov. Steve Beshear's administration will announce next week details about managed-care contracts for Medicaid, the federal-state health care program for the poor, aged and disabled. The administration previously said that it expected the managed care contracts to be signed by Friday, the beginning of the 2012 fiscal year. ... How soon those contracts are signed and for what amount is key to balancing the 2012 fiscal year's budget. The legislature passed a budget this year predicated on more than $166 million in savings in the $6 billion Medicaid program. Beshear had pledged that he would generate savings in the program through managed care and other cost-saving measures as a way to plug a hole in the budget (Musgrave, 7/2).

Louisville Courier Journal: Beshear Close On Medicaid Plan But Misses Deadline
State officials are close to announcing who will take over most of its Medicaid program, Gov. Steve Beshear said Friday. But they didn't meet a self-imposed deadline. ... Meanwhile, advocates for the thousands of Kentuckians who receive health care from Medicaid said they are increasingly anxious to learn which company or companies will be selected to run most of the $6 billion-a-year, federal-state health plan for the poor and disabled. "I think there's a lot of suspense about how this thing will roll out," said Sheila Schuster, a longtime advocate for people with mental illness and disabilities. "The sooner we know who the players are, the sooner we can start talking implementation" (Yetter, 7/1).

Denver Post: Colorado Lawmakers Worried About Proposed Medicaid Rule Change, But Providers Back Idea
Colorado lawmakers are warily eyeing a proposed federal rule that would make it harder to cut fees paid to health care providers that serve Medicaid patients. The proposed rule could take away a tool that state legislators have used to save millions of dollars as they have worked to balance the budget in recent years. Colorado has cut Medicaid-provider rates for the past three budget cycles, reducing state spending by more than $120 million. The cuts — up to 6.25 percent in some cases — have affected payments to physicians and durable medical equipment providers as well as home- and community-based health services (Hoover, 7/3).

Arizona Republic: Feds: Arizona Can Start Medicaid Freeze July 8
Arizona got a reluctant go-ahead from federal health officials Friday to cap enrollment for a portion of the state's Medicaid program, putting health care for thousands of Arizonans at risk (Reinhart, 7/2).

Honolulu Star Advertiser: Doctors Shun Medicaid
The mystery shopper program, scrapped after doctors and politicians criticized it as government snooping, would have measured the level of access for patients insured in a public program versus higher-paying private insurance offered by companies such as Hawaii Medical Service Association. Local health care providers had hoped the short-lived proposal to survey difficulties in accessing care here and in eight other states — through people posing as patients with different kinds of insurance coverage seeking primary-care appointments — would have prompted government action, making it less burdensome for doctors to accept publicly insured patients (Consillio, 7/5).