FY 2013 Medicaid Budget Overview Medicaid Advisory Committee January 23, 2012

2 FY 2013 Medicaid Budget Allowance Provider Reimbursement …. $7 B ($2.5B GF,.9M SF) MCHP ………………………. $200 M ($ 64.2M GF) Kidney ………………………. $11.9 M ($8.5M GF) Administration ……….…….. $103 M ($ 24.9M GF) Total ………………….....….. $7.3 B ($2.6B GF,.9M SF) 3% increase or $ 238M TF increase over FY 2012 appropriation

3 FY 2013 Allowance Additions (GF) Increase in funding for OAW slots …………..……….. $4.5M Increase in funding for LAHW slots …………..……… $4.5M Increase in NH rates by 1% …………………………….$5.5M Increase in Community Provider rates by 1.5% ………..$2.8M Physician fee increase to bring E&M codes up to………$17M Medicare levels per Federal guidelines Allocation of funds for internal staff to support implementation of a new MMIS system ……… $0.5M

FY 2013 Allowance Additions (GF) cont’d Additional funds for MHCC’s Primary Care …………$.7M Medical Home project Fund the Chronic Health Home project …………...… $1.5M Additional funds for personal care services……….....$2.6M through use of funding available from eliminating the Nursing Facility bedhold payments Keep PAC open……………………………………….$7.4M 4

5 Cost Containment and Adjustments Included in FY 2013 Allowance (GF) MCO 1% reduction ……………………………..… $15.9 M Accelerate the MCO MLR recovery to 100% ……. $3M Reduce the medically needy inpatient hospital benefit package …………………………………. $36M Implement tiered outpatient rates which means different rates for different types of services …… $30M Implement a DSH pool …………………………... $9.1M Continue freeze in rates for DC and non HSCRC hospitals ………………………………………… $1.5M

6 Cost Containment and Adjustments Included in FY 2013 Allowance (GF) cont’d Eliminate NH communicable disease ………………. $5.8M care payments Reduce durable medical equipment payments to 90% of Medicare …………………………………$1M Implement the In Home Supports Assurance Program. $2.8M Move ESRD to Medicare ……………………………..$1M Identify dual eligibles and apply for Medicare ………. $1M Review denied Medicare services which should not be billed to Medicaid ………………………... $1M

Cost Containment and Adjustments Included in FY 2013 Allowance (GF) cont’d Move MCHP eligible children from Medicaid ……. $1.5M Continue SSI project with DHR which compares SSI recipients with the federal approved lists ………………………………… $3.6M Pharmacy initiatives in the area of antipsychotic medications (i.e., improve use of generics; dose optimization; and new peer to peer UR) ………..….. $5M 7

Increase in Provider Assessment Rates Nursing Home increased from 5.5% to 6% …………………………. $5.5 M New Medical Day Care of 5.5% ……………………………… $3.4 M 8

Thank you, members of MAC Your work, last fall, directly led to: Major rebalancing initiatives Savings in areas of DME, DMS Improved approach to hospital OPD Elimination of communicable disease add-on Protecting PAC eligibility Investment in Chronic Health Home Accountability of ISAS 9