MAY MEDICAID NEWS RECAP

The U.S. Department of Health and Human Services (HHS) has made clear that federal orders allowing pharmacists to order and administer FDA-authorized COVID-19 tests supersede state limits on scope of practice, and in at least one case has instructed a state pharmacy association to stop preventing pharmacists from testing for COVID-19. Now states are taking the baton, making widespread testing a possibility by creating pathways for pharmacists to bill for these services.  read more

Five insurance companies were awarded contracts worth nearly $8 billion a year to manage most of Kentucky’s Medicaid business, Gov. Andy Beshear announced Friday. Landing the contracts were Aetna, Humana, Molina Healthcare, UnitedHealthcare and WellCare, Beshear said. About 1.4 million people in Kentucky receive health coverage through Medicaid. The Democratic governor refers to health care as a “basic human right.”  read more

Public officials in New Mexico continue to contemplate a possible transition to single-payer healthcare in the midst of the coronavirus pandemic. Preliminary results of a study commissioned by New Mexico’s Democrat-led Legislature in 2019 were released Tuesday that outline the consequences of combining nearly all financing for healthcare services behind a single, state-administered payer for all residents.  read more

As many people lose jobs and income due to the COVID-19 outbreak, a growing number will become eligible for Medicaid. To support states as enrollment in Medicaid grows and ensure enrollees maintain coverage, federal legislation provides states a temporary 6.2 percentage point increase in the federal matching rate and establishes conditions states must meet to access the enhanced funding. Beyond the conditions to access the enhanced funding, states can take a range of actions to expand Medicaid eligibility and make it easier for people to enroll.  read more

Missouri voters will get to decide whether to expand Medicaid eligibility. Secretary of State Jay Ashcroft has certified an initiative petition intended to expand government-funded health coverage and put the question on the election ballot. Ashcroft left Gov. Mike Parson a little time to choose whether to switch the ballot measure from the November general election to the lower turnout primary election in August.  read more

Lawmakers will meet on Thursday for just one day to finish out the 2020 legislative session, as while they have no plans to discuss Medicaid expansion, some Kansans are urging lawmakers to pass it. Medicaid expansion seemed likely to pass this year after bipartisan support on a compromise bill in January. But after delays in the Kansas Senate and the coronavirus cutting the session short, expansion has been put off until next year.  read more

States are facing higher Medicaid spending and higher enrollment than expected in 2020 due to the coronavirus, and that impact could continue into the following year, a Kaiser Family Foundation (KFF) survey found. KFF and Health Management Associates (HMA) conducted a survey of Medicaid directors in all 50 states and the District of Columbia and received responses from 38 states. Not all states had data ready for review at the time of the survey.  read more

The coronavirus pandemic has generated both a public health crisis and an economic crisis, with major implications for Medicaid, a countercyclical program. During economic downturns, more people enroll in Medicaid, increasing program spending at the same time state tax revenues may be falling. To help support states as enrollment in Medicaid grows and ensure existing enrollees maintain continuous coverage, the Families First Coronavirus Response Act (FFCRA) authorized a 6.2 percentage point increase in the federal match rate (“FMAP”) (retroactive to January 1, 2020) available if states meet certain “maintenance of eligibility” (MOE) requirements.  read more

The Republican-controlled Oklahoma Legislature gave final approval Friday to two separate measures designed to boost funding for the state’s Medicaid program. The House narrowly approved a bill that will increase a fee that hospitals pay from 2.5% to 4% that would generate about $134 million annually to help fund the state’s share of Gov. Kevin Stitt’s proposed Medicaid expansion, dubbed Soonercare 2.0.  read more

States are about to face a major budget crisis due to exponential growth in Medicaid enrollment and a decline in tax revenue, which experts say could lead to provider payment cuts or other measures to contain costs. Unemployment has been skyrocketing due to the COVID-19 pandemic, which will likely lead to an increase in the Medicaid rolls. With that comes increased costs for states, where Medicaid is the often the biggest budget item.  read more

The Utah Department of Health plans to take steps to lower prescription drug costs for Medicaid following audit The Salt Lake Tribune, May 14

A new performance audit released by the Utah Legislature shows that by making a few adjustments, the Utah Department of Health could save the Medicaid program up to $3.4 million a year. “It’s great to see this audit come out to give the Department of Health more information on how to lower the cost of pharmaceuticals for the Medicaid program,” Courtney Bullard, education and collaboration director at Utah Health Policy Project, said in an interview.  read more

As the coronavirus upends the state’s economy, Medicaid added 140,000 Ohioans in April alone, meaning that the taxpayer-funded health insurance program now covers about 1 in 4 residents. It’s going to get worse. Ohio Medicaid Director Maureen Corcoran said she expects caseloads to continue to increase by about 100,000 in May and again in June, with enrollment nearing 3 million.  read more

Florida’s economic collapse due to the COVID-19 pandemic is expected to cause ballooning Medicaid enrollment that might blow a $1 billion hole in the state budget, according to new projections by the agency that oversees the healthcare safety net program. The dramatic rise in costs could exert additional pressure on Gov. Ron DeSantis and the Legislature to cut the budget as businesses shutting down and scaling back have dramatically reduced the main sources of tax dollars used to pay for state spending.  read more

States facing sudden drops in tax revenue amid the pandemic are announcing deep cuts to their Medicaid programs just as millions of newly jobless Americans are surging onto the rolls. And state officials are worried that they’ll have to slash benefits for patients and payments to health providers in the safety net insurance program for the poor unless they get more federal aid. State Medicaid programs in the last economic crisis cut everything from dental services to podiatry care — and reduced payments to hospitals and doctors in order to balance out spending on other needs like roads, schools and prisons.  read more

 

Another 3.8 million Americans filed for unemployment last week, bringing the total of out-of-work Americans to more than 30 million since the outbreak unfolded. That presents an opportunity for insurers like Molina that are primarily positioned in Medicaid and Affordable Care Act exchange lines of business. Medicaid coverage is based on income and reserved for low-income Americans and the marketplace, or exchanges, tie coverage to income and financial help for those with incomes below a certain threshold.  read more