AUGUSTA, Maine — A state panel charged with finding short-term savings and recommending long-term reforms for the state’s Medicaid program met for the first time Tuesday, just days before the LePage administration hopes to gain federal approval to make $20 million in Medicaid service cuts this fall.
The MaineCare Redesign Task Force met in Augusta to start work on finding $5.25 million in savings this fiscal year and making recommendations to lawmakers on long-term changes to the program that reduce the cost of providing health care to low-income residents.
“We need to be on dual paths, identifying where there might be possible savings, but continue to look at the longer-term focus for the program,” said Health and Human Services Commissioner Mary Mayhew.
The panel’s nine members — who include members of the state’s MaineCare Advisory Committee and others with expertise in health policy, health care finance and state finance — started setting goals Tuesday for a Medicaid program that provides patients with high-quality care at a reduced cost.
“The goal is going to be better coordination, low-cost services and, hopefully, elimination of duplication of services,” Dr. Kevin Flanigan, medical director for the state’s office of MaineCare services, told the group.
The MaineCare redesign panel was formed as part of a supplemental budget package approved by Republican lawmakers in May. That budget package also included Medicaid cuts, planned for Oct. 1, that would eliminate coverage for 19- and 20-year-olds, tighten income eligibility requirements for low-income parents and scale back Medicaid access for elderly residents who also qualify for Medicare benefits.
It’s still unclear whether Maine will be able to make some of those $20 million in cuts as they could run afoul of a provision in President Barack Obama’s federal health care law — known as “maintenance of effort” — that requires that states maintain existing Medicaid services in advance of a major Medicaid expansion in 2014.
Maine officials are awaiting a decision from the federal Centers for Medicare and Medicaid Services on whether they can make those cuts simply by amending Maine’s state Medicaid plan. The LePage administration has interpreted the Supreme Court’s June decision largely upholding the federal health care law as a sign it can make the cuts while Democrats, Health and Human Services Secretary Kathleen Sebelius and others have come to the opposite conclusion on whether the court decision affected the maintenance of effort provision.
Gov. Paul LePage has called for cuts to Maine’s Medicaid program ever since he took office last year. Maine has above-average rates of Medicaid coverage — 27.8 percent of the population in fiscal year 2009 compared to 21 percent nationally — and LePage has said the program’s growth has been unsustainable.
Maine spent about $770 million from its general fund to cover Medicaid services during the 2011-12 budget year, according to the state Department of Health and Human Services. The federal government kicked in nearly $1.5 billion to cover most of the remaining Medicaid costs that year.
According to the Department of Health and Human Services, Maine’s Medicaid program currently covers about 341,000 residents.
The MaineCare Redesign Task Force discussion Tuesday didn’t focus on pending cuts to the program. Instead, the panel devoted much of its attention to the 5 percent of highest-need MaineCare patients who consume about 50 percent of the program’s resources, the bulk of whom are elderly and disabled.
“This is a group that is fully dependent and vulnerable, so we’re not going to get them to leave [Medicaid],” Flanigan said.
But many high-need patients also receive services from other assistance programs within the Department of Health and Human Services, Flanigan said, and that’s where there might be an opportunity to save money through closer coordination of services among those different agency programs.
For example, an asthma patient receiving housing assistance might be able make fewer costly emergency room visits if he were placed in a housing environment that didn’t trigger symptoms of his chronic condition, Flanigan said.
“There is a strong belief we can do a better job of helping these people live more fulfilling lives and not spend time overutilizing [Medicaid services],” he said.
The panel has a Nov. 15 deadline to deliver its recommendations to the Legislature.
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Pro life until birth —is the “compassionate conservative” way.
Yeah, I know who the “pro life” party is, most of them are on BDN comment section all day whining about social services cuts! These services are not FREE. Someone has to work and pay taxes to suppot them. I’m 64 and been sacking concrete panels all day. Do I feel bad for those that watched Oprah today while I paid their way? NO I DON’T! There used to be an old saying “nothing in life is free”, not today. everyone feels their entitled for something. Enough is enough!
Exactly, they have a sense of entitlement yet never have nor ever will contribute anything. Some are deserving by no choice of their own but there are too many who make qualifying for disability & whatever fringe benefits that accompany a career. Who the hell do they think pays for their free ride????
I think we all know which Party the pro-life Party alleges to be. If you don’t, take off the blinders.
I know someone who got a list of items to be cut from MaineCare, through a letter from DHHS about pending changes. They include equipment used to keep diabetics stable, treatment of STDs, and a number of other items that may well create other issues and problems for current clients with medical needs. Maybe these will save money initially, but I suspect that the cuts will cause more costly problems that Maine will have to deal with later on, and at much higher costs.
I have seen the letter too. Replacement therapy 24 month lifetime limit.Unless approved for prior authorization for extension…not sure of criteria (not enough time for most )(there will be a snowball effect the community will not be prepared for).. Pain clinic referral for narcotics and limit on prescribing unless terminal(no problems- this needed change)clients with mainecare are to go to PCP for treatment of STD’s as will no longer pay for the clinic(more expensive and not confidential. Most likely people will not get treatment). Nicotene replacement covered for pregnancy only(senseless). Diabetic testing/supplies no longer covered.(More emergency visits) This is almost in the area of deliberate indifference and criminal negligence. As I have stated before, save now and pay many years later. This is a clear example of clear cutting without much forethought.
I’m hoping that the MaineCare redesign panel aren’t a bunch of Lepage boot lickers. If they are then heaven help the elderly!
OK as long as they’re legal and consdierate which LePage may not be.
Start with Methadone clinics and the free rides to get it.
The top heavy management and high paid management needs to be weeded out as many mistakes they have made since the start of the year if these mistakes were made in the private sector you would be out on your ear.The reps.want to get rid of as many dems.as possible and replace them with their cronies.Start looking for cuts within the system first and then look elsewhere.raises to $17.00 per hour are crazy look at the pay for wally world and walmart employees.A far cry from this pay scale and for as many mistakes as they have made.No way it should be allowed
The math from this article indicates that the average per-person cost of Medicaid to the government is $2, 258. Some volunteer work and administrative stream-lining should be able to offset most of that cost. Is there a mechanism in Medicaid for administrative stream-lining and volunteer work? Many seniors love to volunteer and will work for little compensation, just to make a few bucks and be out in the community. Take a lesson, and a few seniors, from Wal-Mart. Moreover, Is there any mechanism to encourage organizational efficiency in favor of bureaucracy and red-tape? The internet only goes so far.
Tax loop-holes allow investment and venture-capital firms ( like Bain ) to reinvest profits at a capital-gains tax rate of 15% instead of the required-by-law-30-some-odd percent simply because they choose, en-mass, to do so. This has been going on for years, the IRS knows it and has taken a position of non-response to this legally-unenforced act of group defiance. This activity is costing the United States billions of dollars in tax revenue each year.
How about instead of asking ma-and-pa to give up food, medicine or both for the sake of a balanced budget only to have a directly-proportional increase in emergency-care costs, we tighten up the corporate investment and venture-capital tax laws and shoe-horn a few fat-cats into playing the game legally, then use the additional tax revenue to fund a humane system of care for our senior citizens, most of whom helped build this country? Seems a compromise rate of say, 25% might be in order.
Trouble with the GOP bean-counters is that there’s no line-item or assignable formula to account for being a hard-working, law-abiding, tax-paying all-around mostly decent
American citizen.
We Don’t need medicaid reform half as much as we need corporate tax reform!
Note to the system: the foundation of your your existence is, literally, the collective work of their generation. But then, the “You didn’t build that” comment went right over your heads, so I don’t expect this to make any sense for you, either.
Maybe November will clear that up.