NC Medicaid Committee Hears Options For Cuts

North Carolina's Medicaid agency is unveiling its ideas for about cutting payments to doctors and services for patients.

The state Department of Health and Human Services on Friday plans to tell how it will start complying with the Legislature's budget cuts from health care plan for poor children, older adults, and the disabled. An agency spokesman says lawmakers decided to cut $760 million over the next two years.

An advisory committee on state Medicaid issues will hold a public forum to discuss the cuts that will come by paying doctors and hospitals less, reducing services, and increasing vigilance against fraud.

The North Carolina Budget & Tax Center says fewer doctors will accept Medicaid patients if their payment rates are cut substantially, leading to health care layoffs.

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  • by Registered Nurse Location: ENC on Aug 8, 2011 at 11:43 AM
    An estimated 60 million Americans are covered by Medicaid, with the enrollment numbers swelling due to the economic recession. To add further stress to the system and state budgets, the new PPACA healthcare reform legislation could add 16 to 23 million to the Medicaid rolls due to Medicaid expansion. In our fair state, Medicaid already covers 20% of the population, with the remaining 80% paying the costs through their taxes. These numbers could increase 150-200% under the PPACA. Our financially-strapped state simply cannot afford this projected increased enrollment in a program that is already bleeding our state dry. Therefore, reform is desperately needed if our state is to maintain fiscal solvency.
  • by Registered Nurse Location: ENC on Aug 8, 2011 at 11:33 AM
    The federal government’s share of costs (based on per capita state income) is 65% in North Carolina. Our state pays the remaining 35%, with Medicaid being the second costliest ticket item in the NC Budget (education, of course, being first). Patients usually pay no part of the costs for covered medical expenses, although a small co-payment may sometimes be required. I would advise the NC Medicaid Committee to require a small copay of $3 for each and every ER visit. This would help weed out some of the egregiously frivolous visits, such as coming into the ER for hang nails and stubbed toes.
  • by Registered Nurse Location: ENC on Aug 8, 2011 at 11:27 AM
    States must provide 16 basic services for the elderly on Medicaid—including hospital inpatient services, hospital outpatient services, physician services, nursing facility services, home health care for persons eligible for skilled nursing services, and laboratory and x-ray services. But, other services are optional, such as rehabilitation, physical therapy, hospice, prescription drugs, and transportation. North Carolina offers 27 of the optional services allowed by the federal government. You can bet that many of these optional services will now be cut, especially with the pressures of the new healthcare legislation (PPACA) looming.
  • by Registered Nurse Location: ENC on Aug 8, 2011 at 05:50 AM
    I would hope those on the NC Medicaid Committee will not be "penny wise and pound foolish." For instance, cutting supports to community-based long-term care (i.e., home health, vouchers for adult health day care, and other community-based services) will result in Medicaid recipients ending up in exorbitantly expensive institutional long-term care (nursing homes), as there will be no alternative for these people to institutionalization. The average monthly cost per nursing home resident in NC is $6000. Community-based services are much less expensive and are a more efficient use of scarce taxpayer funds.
  • by Anonymous on Aug 8, 2011 at 04:26 AM
    Too many UNNECESSARY emergency room visits. Something should be done about this.
    • reply
      by Registered Nurse on Aug 8, 2011 at 05:55 AM in reply to
      EMTALA requires a "medical screening exam" for everyone who presents to the ED. If the facility doesn't strictly comply, the facility can lose all CMS funding. With these proposed cuts to providers, I predict that many financially-strapped community hospitals will ONLY provide the medical screening exam to Medicaid patients presenting to the ER and nothing else, if their presenting condition does not warrant it. If their condition is not emergent, they will be given the quick medical screening exam, and then "streeted."
  • by RK Location: BOCO on Aug 5, 2011 at 08:42 PM
    Instead of cutting the facilities that treat sick people...why don't the government begin their cuts by drug testing the recipients. If they test positive then cut them off. Two other states have already passed this law. Secondly, welfare was not started to be a way of life, but a temporary assistance until one is able to provide for their own family. Medicaid needs to be totally revamped, not the facilities that accept their low payments!! Stop paying for every child that is had for a paycheck.
  • by Hello Location: Goldsboro,NC on Aug 5, 2011 at 11:50 AM
    I think the cuts need to be made with prescriptions.I know a lady who is getting 90 percocet a month.She will not weigh 90 pounds soaking wet.That is 3 per day.She is 78 years old and her doctor only takes a urine sample every 3 months just to see if they are in her system.My point is with medicaid she only pays 3 bucks for them.We pay the rest.She also goes to the most exspensive pharmacy their is.Pharmacies need to be regulated on prices too.It is not fair to the ones that end up forking this bill when they charge $200.00 for a medication and with medicaid the price is only 3 dollars.Go figure
    • reply
      by Registered Nurse on Aug 8, 2011 at 05:57 AM in reply to Hello
      It is a well-known fact for those of us who work in the emergency room setting, that many patients will "prescription shop" from ER to ER, to get scripts for Percocet, Vicodin, and other narcotics. These pills can then be sold for $10 or so apiece on the street. Our tax dollars at work... don't you just love it?
  • by Anonymous Location: Ahoskie on Aug 5, 2011 at 07:41 AM
    Way to go Kay. Medicaid fraud is rampant in Hertford County, particulary with personal care service. Unfortunately the elderly who needs it can't get assistance, probably like the elderly man in Bertie County who killed his wife out of despiration and then killed his wife could have benefit from Medicaid PCS. The owners of personal care services agencies are paying their staff to go door to door to see who has the "blue medicaid card" and then sign them up for someone to clean their house and ride them up and down the road. I'm talking about healthy period. Shame, Shame, Shame. It's long overdue. Hardworking taxpayers are sick of it
  • by Stop the junk on Aug 5, 2011 at 07:31 AM
    I also think they should cut food stamps. They should not be able to buy any junk food at all. I have seen people go to the store and buy drinks, chips, candy- all name brand and did'nt have any meat or fruits up there at all. If you go and apply for food stamps and medicaid with all that jewlery and nice name brand clothing and a new vehicle, you should'nt be able to get anything. I work for what I get and I still cannot afford what these people on welfare have. This really sucks to. There is a free clinic in Grimesland and Fountain- send them there.(Or free to them)
  • by confused Location: ENC on Aug 5, 2011 at 06:40 AM
    I've had cancer, bladder erosion to the colon, two shoulder surgeries, one knee surgery, have hep c, copd, enphazema, sleep apnea, and several other health problems that I choose not to mention. I worked all my life and paid taxes all my life. To have health ins right now would cost more than my $674.00 a month I receive, so tell me, why would I not be deserving of medicaid? without it, I would be dead already. Go ahead and cut my SS check. Go ahead and cut my mediciad. I'm just another senior that paid all his life to programs that he thought would be there for him. Get the illegals and the fraud out of these programs and there are the cuts we need to make. Please don't kill me with these other bulls--- cuts.
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