Projected Hospital Impact FY 2007 Medicaid Budget
Medicaid Provision Executive Senate House
Projected Impact to Hospitals
Provider payments. No change
Graduate Medical Education
Payment through HMOs.
OPTIONAL GROUPS
19/20 yr olds Caretaker Relatives Adult Benefits Waiver Population
No change No change No change No change No change
Medicaid DSH Co-pays & Deductibles
For information on the FY 2006 Michigan Department of Community Health budget, please refer to the back of this document.
Projected Hospital Impact FY 06 Medicaid Budget
Medicaid Provision FY 2006 Enacted CMS Waiver or SPA (State Plan Amendment) Approval & Other Notes
Projected Impact to Hospitals
4 % reduction to provider payments. Providers include hospitals, physicians, home health care, long term care, dental, children’s special health care. All plans include forgoing second year of HMO actuarial rate increase. Implement Hospital Observation Rate Graduate Medical Education Eliminate retroactive Medicaid eligibility OPTIONAL GROUPS
Medicaid - $ 119.6 million (11.1%); Medicare $8 million
Restore 1% of the 4% reduction to provider payments. Restoration of funding is contingent upon CMS approval of inpatient hospital case rate for Caretaker Relatives.
- $ 22.1 million (2.07%) Reduce inpatient payments -$4.7 million (.44%) 4% Executive order cut Restored $0 Included (Subject to CMS approval of Waiver) - $ 50 million (-4.7%) Budget assumes enrollment freeze for this group, pending CMS Waiver Approval. Also implements Limited benefits— annual limit of 20 days inpatient coverage, 4 prescriptions limit per month. (Group will be eliminated via ―age out‖ in 2 years) - $3.7 Million (-.03%) Restores coverage – implements hospital case rate which will make patient days eligible for inclusion for Medicare DSH purposes. CMS waiver approval required for implementation of case rate. [June 2005 Waiver included annual inpatient limit of 20 days coverage and 4 prescriptions per month]. - $ 22.9 million (2.1%) Establish asset test for determining eligibility of parents and caretaker relatives - $4.7 million (.44%) Restore coverage – no change from 2005. $0 No change from 2005. Revised co-pays (Subject to CMS waiver approval.) $2 co-pay for physician office visit. $50 deductible for first day of inpatient hospital stay $3 co-pay for E/D visit $1 co-pay for hospital OP visit (Data not available to determine impact of OP co-pay.) - $ 11.5 million (-1.1%) No premiums Restored coverage for optional populations will allow hospitals to continue including those IP days for Medicare DSH purposes. However, elimination of retroactive eligibility will decrease IP days and Medicare DSH payments. - $ 8 million
Policy change. This likely won’t impact inpatient payments.
Requires CMS Waiver Approval (no specific timeframe for waiver approval by CMS)
19/20 yr olds
Requires CMS Waiver Approval (no specific timeframe for waiver approval by CMS)
Caretaker Relatives
Requires CMS Waiver Approval (no specific timeframe for waiver approval by CMS) Asset test will require CMS approval of a policy change and SPA, with MSA anticipating April 2006 effective date for asset test.
Adult Benefits Waiver Population
Medicaid DSH Co pays and deductibles for certain fee for service Medicaid services
Requires CMS approval of policy change and SPA. Proposed policy bulletin recently released for public comments (due 11/23/05), with Jan. 2006 effective date.
Monthly premiums for certain Medicaid Beneficiaries Indirect Reductions: Medicare DSH Loss
For additional information on the state Medicaid budget, please contact David Finkbeiner, senior director, legislative issues, MHA at (517) 703-8604 or dfinkbeiner@mha.org.