The state is delaying its move to put 27,000 kids in child welfare programs into a managed care plan.
The Georgia Department of Community Health told GHN on Friday that the managed care program requires more time to launch. It will begin March 3, instead of the originally planned Jan. 1, an agency spokeswoman said in an email.
The move of foster care children and those in adoption assistance and in the juvenile justice system will result in improved coordination of care, state officials say. The new program is also expected to save Medicaid millions of dollars by emphasizing prevention and keeping the children healthier.
The Community Health spokeswoman, Lisa Marie Shekell, said in an email that the agency “remains committed to this transition because of the improvements in care and health outcomes that the children and youth impacted by transitioning into a managed care environment will experience.” full story
Calculating the cost to taxpayers, a new study released Thursday says Georgia could see a net loss of $2.9 billion in the year 2022 if it continues to reject Medicaid expansion.
That’s because Georgia taxpayers would be paying for expansion of Medicaid in other states, while not getting anything in return, said the Commonwealth Fund study. Additional federal funds go to states that expand Medicaid.
The Supreme Court made expansion optional for states.
Only Texas and Florida would have net losses higher than Georgia among 20 states that have opted not to expand Medicaid, said the study, conducted by Sherry Glied and Stephanie Ma of New York University.
Georgia would see a net loss of $2.86 billion in 2022 if it were the only state remaining that did not increase its Medicaid program to cover more low-income adults, said the study, which takes into account the federal taxes paid by state residents for other states’ expansions.
“The Medicaid expansion presents an opportunity for states to bring in new federal dollars, in addition to providing critical health coverage for their low-income residents,” said Glied in a statement. “No state that declines to expand the program is going to be fiscally better off because of it. Their tax dollars will be used to support a program from which nobody in their state will benefit.” full story
More than 900 U.S. nursing homes, including six in Georgia, have been listed by federal officials as not fully complying with a regulation to have automatic fire sprinklers in every patient area.
The Centers for Medicare and Medicaid Services (CMS) sent a memo to state officials last week on the sprinkler rule compliance. It did not identify the nursing homes that are not fully sprinkler-equipped. The deadline for installation was Aug. 13.
In 2008, CMS issued a rule that the long-term care industry had five years to install the systems in the approximately 16,000 U.S. nursing homes, where more than 1 million Americans live.
The federal rules came in response to the deaths of 31 people in nursing home fires in Nashville, Tenn., and Hartford, Conn., in 2003.
After the deadly fires, “there was enormous pressure on CMS to respond,’’ said Alan Horowitz, an Atlanta attorney with law firm Arnall Golden Gregory who specializes in long-term health care issues.
Georgia’s record appears to be good compared with other states on the rate of compliance with the sprinkler regulation. full story
A state agency is updating its hospital coding system for the Medicaid program to meet federal requirements next year.
The current “diagnosis related groups” (DRG) system used to reimburse Georgia hospitals is based on cost data derived from 2004 and 2005, and the new one will use 2011 and 2012 data, the Department of Community Health said this week.
Every state Medicaid program has to be compatible by October 2014 with a new coding system, said Tim Connell, chief financial officer of Community Health.
The update will, in effect, create winners and losers among 152 hospitals in the state, with some benefiting financially from the change and others losing some revenue.
Grady Memorial Hospital would lose the most under a preliminary calculation, but the state is exploring options that would reduce the loss to Atlanta’s biggest safety-net hospital, Connell told GHN. full story
President Obama’s decision Thursday to allow people to renew their canceled insurance policies for a year appears to have left as many questions as answers among health care analysts.
Facing a storm of criticism about canceled policies, Obama announced an administrative change to let insurers continue offering individual plans for another year, even if they don’t meet the Affordable Care Act’s minimum benefits.
In Georgia, to a large extent, such a remedy is already available. Many health insurers in Georgia are allowing individuals to retain their policies through late 2014.
GHN reported earlier this month that most Georgia insurers are letting consumers have an option to renew their plan before Jan. 1 and avoid the ACA’s benefits requirements.
President Obama signs the health law in 2010
Obama’s announcement came a day after federal officials released enrollment figures for the health insurance exchanges. In Georgia, 1,390 have signed up for a health plan through the exchange, the Department of Health and Human Services said.
But Glenn Allen, a spokesman for state Insurance Commissioner Ralph Hudgens, said Thursday that based on Georgia insurers’ data, the number of applicants who have given sufficient information to enroll through healthcare.gov is actually 536.
How the year’s extension of canceled policies will play out nationally is unclear. Insurance industry officials and experts expressed concern that the policy shift could lead to higher premiums. full story