1. Department of Health and Social Services Division of Medicaid & Medical Assistance Joint Finance Committee Hearing Fiscal Year 2012 Rosanne Mahaney Division Director Thursday, March 3, 2011

2. Delaware Health and Social Services Overview Medicaid Delaware Healthy Children Program (CHIP) Delaware Prescription Assistance Program (DPAP) Chronic Renal Disease Program (CRDP) Legal Non-Citizen Healthcare Program

3. Delaware Health and Social Services Opportunities & Accomplishments The Affordable Care Act Enhanced Federal Match for Medicaid Expansion in 2014 $1 million Health Benefit Exchange Planning Grant $400,000 MFP/ADRC Grant Program Integrity Efforts o Recovery Audit Contractor (RAC) o $1 million in Collections in SFY ‘10 o National Correct Coding Initiative (NCCI)

4. Delaware Health and Social Services Opportunities & Accomplishments (cont’d) ACA Quality of Care and Payment Improvement Provisions Electronic Health Record (EHR) Incentive Payment Program Money Follows the Person Program Medicaid for Workers with Disabilities Program

5. Delaware Health and Social Services Challenges

6. Delaware Health and Social Services Challenges

7. Delaware Health and Social Services Cost Containment Strategies Benefit Restrictions 34 states have implemented benefit restrictions Service Limitations do not apply to: o Children o Individuals in need of Long Term Care Services

8. Delaware Health and Social Services Cost Containment Strategies (cont’d) Cost Sharing 45 states have either implemented or plan to increase cost sharing requirements Provider Rate Changes 39 states recently implemented provider rate reductions

9. Delaware Health and Social Services Integrated Long Term Care Service Medicaid Recipients FY 2012 Projected GF Cost Nursing Facility Services3,564$94,402,750 Home and Community Based Services 2,089$10,646,662 TOTAL5,653$105,049,412

10. Delaware Health and Social Services FY 12 Governor’s Recommended Budget $52 million to fill the gap created by the loss of enhanced federal funding in SFY ’12 $55.3 million GF will be carried over from SFY ‘11 due to the 6 month extension of enhanced federal match to June 2011 $2.2 million to fully fund DDDS community clients from SFY ’11 $295.5 thousand to fully fund the Chronic Renal Disease Program

11. Delaware Health and Social Services FY 12 Governor’s Recommended Budget (cont’d) Tobacco Funds (ASF) $1,113.7 to fully fund the Delaware Healthy Children Program $1,027.2 to fully fund the Medical Assistance Transition (MAT) Program ($1,250.0) reduction to DPAP to reflect service and administrative savings ($1,570.0) reduction to the Legal Non-Citizen Program

12. Delaware Health and Social Services Legal Non-Citizen Program 100% State-funded Program Pregnant Women and Children Moved to Medicaid & CHIP in SFY ‘11. Now Serves 847 adults

13. Delaware Health and Social Services Thank You