The current timeline for a decision on restructuring Georgia Medicaid may not be feasible, a state official indicated to lawmakers Wednesday. Blake Fulenwider, deputy...

The current timeline for a decision on restructuring Georgia Medicaid may not be feasible, a state official indicated to lawmakers Wednesday.

Blake Fulenwider, deputy commissioner of the Department of Community Health, also told House lawmakers that financial projections on the leading options for a Medicaid revamp have not yet been worked out.

“This is a huge undertaking,’’ Fulenwider said in a briefing to a House health panel a day before the General Assembly was due to adjourn for the year.

The hearing focused on a recent state-commissioned report on the future of the Medicaid and PeachCare programs.

That report, by the consulting firm Navigant, calls for Georgia to consider adopting an enhanced managed care system that would cover aged, blind and disabled Medicaid beneficiaries.

The state currently operates a managed care system for all PeachCare and most Medicaid members. Patients with disabilities or in long-term care are currently in traditional payment systems.

Rep. Butch Parrish (R-Swainsboro), a pharmacist who heads the health subcommittee of the House Appropriations Committee, opened the hearing by noting that there has been “a lot of interest’’ from the panel and from the public on the state’s Medicaid redesign plans.

State officials have previously said they expected to make a decision in April on which option to pursue to restructure Medicaid and PeachCare, which together cover 1.7 million Georgians, with a budget of more than $7 billion, including federal money.

Fulenwider, though, said state officials “are still very much in the analysis phase. I think this timeline is a bit aggressive.’’

Rep. Pat Gardner (D-Atlanta) asked Fulenwider several questions about the state’s decisions. “I’m really looking for accountability that will show the quality of care we’re getting,’’ she said.

Fulenwider said the quality data on Medicaid have improved.

He also said the state was considering the “medical home’’ model employed by North Carolina’s Medicaid program, which is driven by physicians.

But Fulenwider said North Carolina’s program is more expensive than Georgia’s current structure. “It’s very administratively heavy,’’ he said.

The full implementation of the Georgia Medicaid changes is expected in January 2014 –- the same time the full rollout of the federal health reform law is due.

If that law, also known as the Affordable Care Act, is upheld by the U.S. Supreme Court, Georgia is projected to add more than 650,000 new members to its Medicaid program.

The cost of that expansion to Georgia from 2014 to 2020 would be $2.4 billion, though the federal government would kick in much more money, Fulenwider said.

But he also noted the widespread uncertainty about the future of the health care law, which was argued before the high court this week. A ruling on it is expected in June.

Whatever changes Georgia will institute in 2014 will be phased in and not all launched at once, Fulenwider assured the panel.


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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