The Centers for Medicare & Medicaid Services told Florida officials it could not extend the state's current managed care waiver for Medicaid to a statewide program. The pilot program, granted a waiver to run in five counties in 2006, has been the model for recent efforts by the state to reform its Medicaid program.
But CMS said no waiver would be forthcoming until the state has finalized its legislation on a managed care program. The Florida House and Senate have both passed state budget bills that contain different versions of Medicaid reform. The Senate version contains a provision that would allow Florida to pull out of the Medicaid program completely if it doesn't secure a waiver, while the Senate and House versions also differ in the number of managed care regions in the state--the House law proposed eight regions, while the Senate version wants 19 separate regions. If the two chambers can agree on a compromise, federal officials have also said they would need to see data from the program that also shows what services have been denied under managed care. State officials have indicated that no such data is available.
Oklahoma legislators agreed to implement a 2.5 percent fee on hospital revenue and use the money to qualify for additional federal Medicaid matching funds. The bill, approved by a 39-9 vote, would generate roughly $152 million from the hospitals, which would be earmarked for the state Medicaid program. That money would allow the state to access an additional $269 million in federal matching funds to help hospitals fund care for patients on the state low-income healthcare program. The bill had the support of the Oklahoma Hospital Association, which said it would help hospitals that currently lose money treating Medicaid patients and by avoiding further reimbursement rate cuts.
Texas will expand Medicaid managed care into South Texas, after the state Senate unanimously approved the measure that is expected to save the state $290 million over two years. The plan includes moving Medicaid prescription drug sales into the managed care program at a biennium savings of $51 million. The prescription drug program was opposed by many pharmacists in the state and some legislators also worried that decreased access would make it much more difficult for Medicaid beneficiaries to get needed medication.