State Budget Moves Through Senate Panel

Senate budget writers have given their stamp-of-approval to the $18.6 billion spending plan for Georgia’s 2010 fiscal year ahead. The budget includes a boost of $140-million for Medicaid to help the program keep up with enrollment. To help cover the cost, state employees will be asked to pay a bigger share of their health insurance costs. The spending plan also includes $1.3 billion in federal stimulus funds to help soften the blow of cuts. The budget now moves to the full Senate Wednesday for a vote.

Lawmakers OK Budget, Restore Medicaid Cuts

Budget writers in the Georgia House have restored deep cuts to Medicaid funding that officials warned could have forced some hospitals to shut their doors.

In the spending plan adopted by the House Appropriations Committee on Wednesday, legislators funneled about $200 million in federal stimulus dollars to hospitals and doctors to help offset Medicaid costs. Gov. Sonny Perdue had recommended a 10 percent cut.

Healthcare groups had complained in recent days that while the state was receiving hundreds of millions of dollars in Medicaid money from the federal stimulus package, Georgia was diverting much of that money to other items in the budget that were unrelated to healthcare.

(AP)

Ga. House Panel Approves Budget

The House Appropriations Committee has approved an $18.9 billion budget that funnels hundreds of millions of dollars in federal stimulus money into Medicaid and education.

The amended budget for the current fiscal year passed by a voice vote Wednesday. It cuts more than $2 billion in state spending to fill a deficit. The federal stimulus money coming from Washington is helping blunt some of those cuts.

The budget restores $1.3 million to the state Department of Revenue to keep it from having to furlough auditors.

State lawmakers say that with tax revenues plummeting the state needs the auditors more than ever to make sure that Georgians are paying their fair share.

The full House is set consider the budget Thursday. It still must pass the state Senate.

On The Net: H.B. 118: www.legis.ga.

(AP)

Perdue To Talk Stimulus With Agency Heads

Federal stimulus money starts flowing into Georgia today. An injection of around $340 million is on the way to fill the gap in Georgia’s Medicaid program. Governor Sonny Perdue’s office says eventually, the state should see about $465 million for Medicaid.

Meanwhile, Perdue is back in Georgia today following his trip to Washington for the National Governor’s Association meetings. Perdue this afternoon is scheduled to meet with state agency heads to discuss how federal stimulus money will be parceled-out to the various divisions. Georgia is expected to get $6 billion from the stimulus package.

Federal Money May Nullify Plan to Raise Hospital Taxes

The federal stimulus package may nullify a state plan to charge hospitals and insurers new fees.

The addition of 1.73 billion dollars in federal money for Georgia’s Medicaid has almost certainly killed the proposed levy on hospital revenues, according to legislative leaders and health care industry officials.

A similar tax on health insurer revenues may die as well.

Governor Perdue proposed the fees to fill a projected 200 million dollar shortfall in Medicaid and to help fund the state’s trauma network.

However, Perdue’s spokesperson said earlier this week… the fate of the two taxes is still not finalized.

(The Atlanta Journal Constitution)

CHC Commissioner Details Medicaid Woes; Supports Hospital Fee

Governor Sonny Perdue's controversial proposal to impose a fee on hospitals and health care providers across Georgia was questioned today by lawmakers. Community Health Commissioner Dr. Rhonda Meadows, who supports the plan, testified in budget hearings.

Perdue plans to tax hospitals 1.6 percent of their revenues to fill a more than $400 million shortfall facing Georgia's medicaid program. Meadows says that she has made cuts in Medicaid and Peachcare where possible, but without the tax the programs simply do not have enough money.

"If we don't have the tax, we still have that $423 million hole. That is huge, that is huge."

Meadows says that the fee would add roughly $60 dollars annually to the average health insurance plan. Meadows also projects that this year, 130,000 more people will enroll in Medicaid and Peachcare as a result of high unemployment rates.

Governor offers new plan to charge hospital fees

Rural hospitals worry about a new plan by Governor Sonny Perdue. He wants to cut-down the state’s Medicaid and Peachcare deficit with a new hospital fee. But that proposal could push some rural hospitals over the brink financially.

Within Georgia’s budget deficit of around two-billion dollars is a significant shortfall in funding for Medicaid and Peachcare--insurance for children of the working poor. Bert Brantley with the Governor’s office says it’s a crisis that needs a solution sooner than later:

"If we don’t do something, there will be significant cuts in reimbursement rates to hospitals...in the amount of people that can receive coverage from Medicaid and Peachcare--really some very difficult things that are going to cost us in the long run."

Earlier this year, a plan was put on the table that would charge health insurance companies extra fees. That offering drew strong push-back from insurers. Now, this new proposal would charge every hospital a flat fee based on a percentage of net revenues.

The money would be pooled to draw down more federal money for healthcare. Brantley says it’s something Georgia’s bigger hospitals that specialize in trauma care are clamoring for:

"They want help in the trauma area...they want increased rates for Medicaid. When they cover a Medicaid patient, they don’t get 100-percent for the cost they incur."

But Brantley acknowledges this plan could be a problem for smaller town and rural hospitals across Georgia that don’t offer trauma care and other services covered by federal money. 55 such hospitals in the state are represented by HomeTown Health--the organization’s president and CEO is Jimmy Lewis:

"In rural Georgia especially so many of the hospitals are already cash-starved where we have many who have less than 10 days cash on hand. For them to have to accept a tax on top of what they’re currently doing, especially a tax on current net revenues, would be a catastrophic blow to them."

Lewis says unemployment in rural areas leads to more people who can’t pay for services at those hospitals-making it even harder for hospital cash flow. He says perhaps up to 10 hospitals would be on the brink financially under the proposed fee.

The Governor’s office says the plan is being put forth now to spark full discussion, ahead of the General Assembly session next month.

Report: Georgia could reap millions in fed healthcare aid

A healthcare lobbying group says Georgia will receive more than $700 million in Medicaid funding if a federal economic stimulus package is passed.

Washington, D.C.-based Families USA is pushing Congress to approve an estimated $40 billion healthcare package, as part of the incoming Obama Administration’s expected economic measures.

Ron Pollack is the executive president of left-leaning advocacy group. He says the funding will have a trickle-down effect locally:

“The increased money for the State of Georgia would provide approximately $708 mi llion dollars in new funding to the state, which in turn would create approximately 12,600 additional jobs and spur about 1.3 billion dollars in new business activity in the state.”

Recent State budget cutbacks pared five percent off Medicaid and PeachCare – some 114 million dollars.

A recent Georgia State University report pegs the state at sixth place nationally in uninsured residents. In 2007, about 18 – percent of all Georgians went without health care – above the national average of 15%.

Click here for more GPB News coverage of health care issues.

DCH plans extra fees on private health insurers

In order to keep Medicaid and Peachcare going in its current form, the state’s top health agency wants to expand a plan that would charge private health insurers millions of dollars in extra fees.

The Department of Community Health says the call for statewide agency budget cuts makes the action necessary.

DCH is looking to account for over 100-million dollars in needed funds. Without it, the agency says it might have to drop some people from the rolls of Medicaid and Peachcare.

State lawmakers in 2005 passed a measure approving the fees charged of three national companies managing Medicaid and Peachcare.

Dr. Carla Denise Edwards, DCH chief of staff, says this plan expands fees to HMO’s across the state. It's something Edwards says is crucial:

"Without the managed care fee, the state of Georgia is at risk of losing $90 million that would normally be available to ensuring that we had funds for the Peachcare for Kids program, as well as the Medicare program. Without this fee, we don't have the money to run those two programs".

Kirk McGhee is executive director of the Georgia Association of Health Plans, a non-profit industry trade group. He says this would hurt some individuals and small businesses by "pricing them out" of coverage. McGhee says this is something that has to run through the Legislature.

"Certainly I would think that Georgia taxpayers and consumers and voters would want those decisions to be made not by a single bureaucracy in the state, but be made by the people they elected to make such decisions".

Perdue signs health care reform law

Governor Sonny Perdue signed House Bill 1234, a comprehensive reform of the way the Department of Community Health contracts with Care Management Organizations (CMOs) and to provide benefits for members of Georgia's Peachcare for Kids and Medicaid programs.

Among the provisions in the bill are requiring CMOs to post contracted-providers names on a website so that members can make informed choices about their physicians of choice. The legislation also addresses the dental network and streamlines the appeals process for providers who submit claims to CMOs.

Data breach of Medicaid and Peachcare enrollees

Georgia's Department of Community Health is investigating how private information of roughly 70,000 Medicaid and PeachCare enrollees ended up on a publicly-accessible website. The data included names, birth dates, social security numbers and some medical information of members who get their care through WellCare Health Plans.

Director of Compliance for Georgia's Department of CommunityHealth, Ruth Carr said it was due to human error. "Our foremost concern was making sure all of the affected members were notified as soon as possible," said Carr.

According to a WellCare spokesperson, the information became unsecured on February 12th, when a routine update accidentally removed the security component for the electronic data.

WellCare will offer one year of free credit monitoring to affected Georgians who want it.

Carr said that last year, when patient data stored on a CD was lost in the mail, the Department of Community Health's investigation turned up no result.

Proposed funding could benefit Grady Hospital

The Department of Community Health is working on opening a source of federal funding to more hospitals. But the plan could end up hurting rural or local hospitals if it goes forward, according to a report appearing in the Florida Times-Union.

The proposal would make 33 more hospitals eligible for the payments and give Atlanta’s Grady Hospital about $4.8 million more.

The changes being discussed are for the Disproportionate Share Hospital program, in which the state distributes over $250 million in federal aid to hospitals. This is meant to make up for low reimbursement rates for Medicaid patients and the uninsured.

However, since the program is not expected to grow, it could cost other facilities in the state an average of 3.3 to 3.6% of what they would otherwise have received, according to the report.

A final vote is scheduled for November 8.

Click here for more GPB coverage of Grady Memorial Hospital, and here for other health news.

State dentists want solution for Medicaid children

Officials with the state's dental association say Georgia needs to adopt an insurance system that is similar to other southern states--in order to best serve tens of thousands of Georgia children.

Two of Georgia's three managed care groups--Peach State Health Plan and WellCare--have recently announced they are ending contracts with two dental care providers. The action is expected to affect more than 110-thousand children. Georgia has several organizations that handle insurance for Medicaid children, but some other neighboring states run services through a single administrator. Georgia officials and legislators are expressing interest in adopting a system similar to programs in Tennessee and Virginia.

Increased Medicaid payments could give hospitals much-needed boost

The state agency in charge of Medicaid wants to take advantage of an enrollment slowdown to increase payments to doctors and hospitals.

Years of low reimbursements have left many providers of health care to Medicaid and PeachCare patients in the red.

Trauma care hospitals have suffered the most. Atlanta's Grady hospital has partially attributed its financial crisis to this situation.

In recognition, the Department of Community Health plans to reimburse them at a higher rate than other hospitals.

Increased Medicaid payments could give hospitals much-needed boost

The state agency in charge of Medicaid wants to take advantage of an enrollment slowdown to increase payments to doctors and hospitals.

Years of low reimbursements have left many providers of health care to Medicaid and PeachCare patients in the red. Trauma care hospitals have suffered the most. Atlanta’s Grady hospital has partially attributed its financial crisis to this situation.

In recognition, the Department of Community Health plans to reimburse them at a higher rate than other hospitals.

State fines managed care group for the poor

The state is fining one of its new Medicaid managed care organizations $3.7 million for failing to provide timely patient care.

An audit by the Georgia Department of Community Health found Peach State Health Plan was slow in granting Medicaid families and Peachcare kids permission to receive medical services.

Agency spokesperson Amanda Seals says DCH stands by its year-old privatized managed care program and will work with Peach State.

"The Department takes their obligations very seriously," says Seals. "But, we also still feel that these plans are doing a better job of managing health care and improving the health outcomes while getting a better value for the state dollar."

Peach State is appealing the fine. In the meantime, it has replaced its top executive. The company provides health services for nearly 280 thousand poor and working-class Georgians.

Nursing home residents need new homes

Two nursing homes will lose Medicare funding in 30 days, and many families are worried their loved ones will have no place to go.

The Center for Medicare and Medicaid Services has pulled funding from two nursing homes owned by Rome-based Forum Healthcare group.

It said it had determined that patients at the facilities were in - quote – “immediate jeopardy.”

According to the Rome News Tribune, about half the patients in the two homes are on Medicare. This means close to a hundred patients will either have to move or pay for their care out-of-pocket.

Rome has just five other nursing homes. Only two, according to the newspaper account, have room for more than a couple of additional patients

Forum Healthcare officials say they are appealing the decision and hope to avert the crisis.

Savannah chiropractor pleads guilty to fraud

A former Savannah chiropractor has pleaded guilty to health care fraud. Eric Baty is charged with conspiring to bill more than $5-million dollars worth of false claims to Medicare and Georgia Medicaid. Baty also allegedly filed false bills with private insurers with fake medical records of automobile accident victims. Baty could serve up to 5 years in prison and pay a quarter million dollars in fines.

Bill to limit Peachcare receives blow in Senate committee

The Senate Rules Committee gutted a bill pitched by House Speaker Glenn Richardson (R-Hiram) as a way to reign in the cost of Georgia’s Peachcare child health plan.

As Richardson introduced it, the bill would have required new Peachcare families to make less than 200 percent of the federal poverty level. For example, a family of four would have to make less than $40,000 to qualify-down from the current limit of $47,000. The bill also required enrollees to pay extra for dental and vision care.

The Senate Rules Committee swapped Richardson's language for a more comprehensive overhaul of Peachcare. The new Senate version:
-Expands Medicaid to include children in families that make less than 125 percent of the federal poverty level.
-Requires families that make between 125 and 200 percent of the federal poverty level to pay a premium for Peachcare that amounts to 1.5 percent of their total income.
-Allows families that make between 200 and 250 percent of the federal poverty level to enroll their children in Peachcare for a premium that would be set on a sliding scale in proportion to their income. Current Peachcare families would not be affected.

A task force led by Sen. Greg Goggans (R-Douglas) wrote most of the language. It was news to Richardson.

"It would've been nice for someone to talk to me about this before they tried to hijack the bill," said Richardson before issuing a warning. "If Sen. Goggans is the one who's hijacked this, then he won't be passing anything else in the Georgia House of Representatives and that bill will not pass."

The full Senate must approve the bill before it goes back to the House.