Medicaid news: HHS grants Texas waiver for managed care, denies family planning request; Florida pilot program criticized

The Perry adminstration had asked the federal government for two waivers and was granted one.

Houston Chronicle: Medicaid Waiver Could Be Boon For Texas Hospitals
The federal government on Monday granted Texas a waiver that could mean billions more in Medicaid dollars to hospitals over the next few years in return for having them work together to provide better care for the poor. ... State lawmakers cut deeply into the Medicaid budget this year, in part by requiring all Texas Medicaid patients to be enrolled in private health maintenance organizations for their doctor care. In recent years, patients in most urban areas were covered by HMOs, while patients in many rural counties and the Rio Grande Valley had their doctor bills paid directly by Medicaid (Finley, 12/12).

Texas Tribune: Feds Approve One Texas Health Waiver, Reject Another
The U.S. Department of Health and Human Services has turned down Texas' request to run a family planning program that excludes certain providers -; namely Planned Parenthood -; saying it's a violation of the federal Social Security Act. But in the same breath, federal officials approved the state's request for a waiver to expand Texas' Medicaid managed care program statewide, and to establish funding pools to help providers recoup the costs of uncompensated care. Gov. Rick Perry called the decisions out of Washington "one step forward" and "two steps back" (Ramshaw, 12/12).

Dallas Morning News: Federal Officials Reject Texas' Bid To Bar Planned Parenthood From Women's Program
Federal officials have rejected Texas' attempt to exclude Planned Parenthood, which has some affiliates that provide abortions, from delivering care to low-income women under a special Medicaid program. Cindy Mann, a top federal Medicaid official, said Monday that the federal government cannot renew Texas' version of the Women's Health Program because the state wants to disqualify health care providers that perform abortions or have affiliates that conduct abortions (Garrett, 12/12).

Houston Chronicle: Texas Abortion Provider Exclusion Blocked
"The issue is ... whether a state can restrict access to a qualified health provider simply because they provide other services Medicaid doesn't pay for," Cindy Mann, director of the Center for Medicaid and CHIP Services, said in a phone interview with reporters. "The law does not permit this." Mann stressed that Medicaid "does not pay for abortions and will not pay for abortions" (Ackerman, 12/12).

Texas Tribune: Medicaid Payment Cuts In Texas Worry Therapy Providers
Some cuts to Medicaid reimbursement rates will take effect on Jan. 1, putting Texas' Medicaid spending on par with that of many other states. But as Jessica Mahoney of KUT News reports, providers of physical, occupational and speech therapy worry many could be left without services (Mahoney, 12/12).

Health News Florida: Medicaid Care Hit Or Miss: Report
A consumer-group report released today on the Medicaid Pilot -; the model for a now-pending statewide program -; says some plans gave a lot of primary care, while others gave almost none. ... The Florida Center for Fiscal and Economic Policy study concludes that non-profit networks of hospitals and doctors called Provider Service Networks, or PSNs, "generally provided better access to care than their HMO counterparts (Gentry, 12/12).

The Associated Press/Bangor Daily News: LePage Says Dems Skew Facts, Ignore Fiscal Problems As Medicaid Cuts Debate Heats Up 
Even before state lawmakers begin their review of Medicaid cuts that could leave 65,000 people without coverage, the talk is heating up over Governor Paul LePage's plan to avoid a $220 million state budget shortfall. ... The LePage administration says action must be taken to curb spending for Medicaid, known in the state as MaineCare, because it has outgrown Maine taxpayers' ability to pay for it (Adams, 12/13).

Georgia Health News: $8 Million Medicaid Fraud Scheme Alleged
A former HP contract employee has been indicted on charges that she funneled $8.8 million in provider payments to debit cards that she controlled, the state Attorney General's Office said Monday. Romona Ferrell-Davis was indicted by a DeKalb County grand jury last week. ... The indictment charges that in October, Ferrell-Davis accessed the Medicaid information system at HP and changed the bank routing numbers and account numbers of four Medicaid providers (Miller, 12/12).