Hallandale Alzheimer's In-Home Caregiver Agency, A Family Member HomeCare of Hollywood and Boca Raton Notes The Florida Current: State proposes steep cuts to Medicaid coverage for hospital stays, doctor visits

By Christine Jordan Sexton, 10/25/2011

http://www.thefloridacurrent.com/

After being told by the House that its proposed budget reductions were unacceptable, Agency for Health Care Administration staff looked for additional ways to find "savings."

Its latest list of cuts -- given to members of a Medicaid health care advisory panel on Tuesday -- would limit the number of payments the state would make for doctors visits to two per month and would cut nearly in half the number of days Medicaid would pay for inpatient hospitalizations, from 45 days a year to 23.

The state also has proposed limiting Medicaid patients to 12 emergency room visits per year as well as eliminating chiropractic services, adult dental services, adult vision and hearing care, as well as eliminating pediatric and chiropractic services.

In all, AHCA has come up with and additional $62.7 million in general revenue reductions that are matched by another $300 million in other trust fund dollars for a total $363 million reduction in health-care spending.

Florida Hospital Association lobbyist and Medical Care Advisory Committee member Paul Belcher described the cuts to inpatient days and emergency visits as "an additional opportunity for hospitals to provide uncompensated care."

Paring back inpatient days would reduce hospital reimbursements by a total $156 million from general revenue and trust funds, and the cuts to emergency room visits would trim back another $12.2 million from hospitals.

Belcher also asked whether the proposed cut to inpatient hospitalization days would affect Medicaid managed-care plans, whose capitation rates include a component for inpatient care. The sheet of proposed cuts did not show any reductions to Medicaid managed-care plans.

Medicaid Assistant Deputy Secretary for Finance Phil Williams said the cut would have an effect on managed-care plans but that the agency "did not go that extra step" in calculating the proposal on managed-care plans.

Acting Medicaid Director Justin Senior told the group the agency didn't include the cuts in its original proposal to the Legislature but compiled them after being told by Rep. Matt Hudson, R-Naples and chairman of the House Health Care Appropriations Subcommittee, that its initial proposals to eliminate the MEDS-AD program and limit Medically Needy were "nonstarters for the House."


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