Eliminating a hospital provider fee would create a hole of nearly $500 million in the state’s Medicaid budget, state lawmakers were told Thursday. David Cook,...

Eliminating a hospital provider fee would create a hole of nearly $500 million in the state’s Medicaid budget, state lawmakers were told Thursday.

David Cook, commissioner of the Department of Community Health, outlined the potential fiscal calamity at a budget hearing at the state Capitol. He said that if the Legislature were to reject renewing the fee, the huge deficit would probably have to be made up by cutting compensation to medical providers.

That whole scenario is not likely to happen. A bill to transfer authority over the hospital fee from the Legislature to Community Health is likely to pass quickly, smoothing the way for renewal of the assessment in a non-political setting.

Cook’s stark assessment of the hospital fee for Medicaid was among the most dramatic moments as three state health agencies presented financial information to the Joint Appropriations Committee of the House and Senate.

State agencies were ordered by Gov. Nathan Deal’s Office and Planning and Budget to make reductions to their budgets, reflecting tight revenue growth amid a weak economy.

The three proposed health budgets for this fiscal year and 2014 contained some cuts, but not the extensive pain of some past years.  Agency budgets typically undergo changes before winning final approval from the Legislature and the governor.

Cook noted that his agency, through Medicaid, PeachCare and the State Health Benefit Plan, manages the health care of one out of every four Georgians. Most of its $11.9 billion budget (including federal funds) is spent on Medicaid.

Among the Community Health cuts are:

A 0.74 percent Medicaid and PeachCare reimbursement reduction to health care providers other than primary care physicians, hospitals,
federally qualified health centers, hospice organizations, and rural health clinics.

* The elimination of Medicaid reimbursement for early elective inductions and C-sections prior to 39 weeks.

* Savings from more analysis of the care needed for people in long-term care, and home- and community-based waiver programs.

In the face of such cuts, Tim Sweeney, health policy director at the Georgia Budget and Policy Institute, told GHN that he believes that the fiscal 2014 budget, beginning in July, is underfunded.

He cited an anticipated increase in Medicaid enrollment as the Affordable Care Act brings already eligible children into the program.

Department of Public Health

Public Health’s commissioner, Dr. Brenda Fitzgerald, detailed her agency’s work to boost the health of Georgians, which she said in turn helps the state’s economy through lower costs and higher productivity.

The agency, she told lawmakers, has pursued initiatives to fight childhood obesity, infant mortality, preterm elective deliveries, tuberculosis, HIV/AIDS, and tobacco use. Fitzgerald also said telemedicine is bringing greater access to care throughout the state.

Still, Public Health, with a budget of $684 million, is making some cuts to programs, including from one that helps treat more than 3,000 Georgians with hypertension.

“Hypertension is an enormous problem,’’ Fitzgerald acknowledged. But she added, “We have limited resources,’’ and she mentioned the possibility of a collaboration with private organizations to fight the condition.

Public Health is also changing the payment structure for the Babies Can’t Wait program, which helps thousands of young children with developmental disabilities.


Department of Behavioral Health and Developmental Disabilities


DBHDD won’t have to cut services to consumers, thanks to a one-time $9 million injection of federal funds, said Frank Berry, commissioner of the agency.

The agency’s budget to fund a 2010 settlement agreement with the U.S. Department of Justice is not subject to the state’s requirement for agencies to cut spending by 3 percent, Berry said.

That agreement has helped create new services for people with serious and persistent mental illness, and has moved hundreds of people with developmental disabilities out of hospitals.

“People who lived in a hospital for years are living in their own homes,’’ Berry said.

Yet the Justice settlement is not intended to serve all Georgians with mental health needs, he added.

“That does not address the hundreds of thousands of others needing behavioral health services,’’ Berry told lawmakers Wednesday.

Berry said he has been getting questions about mental health services in the wake of the Newtown, Conn., school massacre last month. The shooter, Adam Lanza, began his rampage by killing his mother, who had sought help in dealing with his mental problems, and he ended it by killing himself.

The answer to concerns about those with mental illness, Berry said, is that the system needs more services –- for screenings, assessments and treatment.

The national events demonstrate the need for a strong safety net, he said. When Georgians have mental health and substance abuse problems, he said, “We’ve got to make services easier for them to access.’’

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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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