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State Budget (Final) Public Hearing

Posted: May 10, 2013

State Budget (Final) Public Hearing

On Thursday afternoon and evening the Senate Finance committee conducted a 6 hour public hearing on HB 1 and HB 2 (State budget). Developmental Services was the again the most advocated program, followed by Domestic Violence Prevention and Substance Abuse Treatment. Many others spoke about various human services programs for children, the elderly and those with mental illness.

Following additional committee work, the Senate votes on its budget on June 6. Commissioner Toumpas will back again before Senate Finance next week on Monday May 13th at 10:00am.

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Step 1 Medicaid managed care gaining speed?

At the May Health and Human Services Oversight committee this morning Commissioner Toumpas provided some new information relative to Step 1 Medicaid managed care. First, there is one MCO that claims to have achieved providers in 80% of the state. It was unclear if this was network adequacy in 80% of the state or simply a presence in 80% of the state. The department continues to suggest that two MCO’s are moving ahead with network progress with the third seemingly behind the first two. DHHS has said they will proceed when two are ready.

The department has created new capitated rates for year 2 of Step 1 (It appears that, the current year 1 Step 1 rates have not and will never be used). These new rates are higher paying than the current rates and seem to be acceptable to Step 1 providers, including Hospitals and Community Mental Health Centers. The new rates would incorporated into a contract amendment.

In addition, there is a new supplemental rate for 3 categories of individuals with severe mental health diagnosis. These supplemental rates will allow the MCO’s to send additional money to not only the Community Mental Health Centers, but also other Step 1 providers such as RX.

Step 3 rates are being planned and worked on with the department’s vendor.

In terms of Step 2, next week, Commissioner Tomas, Nancy Rollins and Jose Montero are traveling to CMS in Baltimore to discuss the SIM program with other states and CMS.

Finally, the Commissioner reported that he has made phone personal phone calls to CEOs of hospitals, especially the “suing hospitals” to encourage them to sign on to Medicaid managed care. Toumpas said that he was very encouraged by most of the responses from the CEO’s and he said many of the hospitals are close to signing agreements with MCO’s.

The Commissioner strongly indicated that he envisions Step 1 commencing toward the end of calendar year 2013.

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