Category Archives: Medicaid/Medicare

Iowa’s estimated savings from Medicaid privatization triples to $141 million, after plummeting 80 percent

Source: Tony Leys, Des Moines Register, May 18, 2018
 
The state’s official estimate of how much Medicaid privatization is saving Iowa taxpayers has suddenly tripled, a few months after it had plummeted 80 percent.   The Iowa Department of Human Services provided no explanation of how it came up with the new number.  State administrators now estimate the annual savings at $140.9 million, according to a letter they sent this week to a legislator. In December, their savings estimate was $47 million for the current budget year, which runs through June.  Former Gov. Terry Branstad predicted in 2017 that the savings for this budget year would be $232 million.  David Hudson of Windsor Heights, who leads an official advisory committee on Iowa’s Medicaid program, expressed frustration after reading a letter from the department to a legislator who asked for the savings estimate. …

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Iowa House again passes Medicaid oversight legislation
Source: James Q. Lynch, The Gazette, April 23, 2018
 
The Iowa House once again has unanimously approved legislation providing oversight of Medicaid managed care to deal with what the bill’s manger called “bumps in the road.”  The House earlier passed similar legislation, but it failed to meet a deadline in the Senate. So the House passed House File 2483 on a 95-0 vote. The earlier version was approved 97-0. … The bill makes a statement “to the Department of Human Services, to the citizens out there who are being served by these managed care organizations, to the providers, that we feel very strongly in doing what we can to provide oversight over the process of this privatized Medicaid approach that has created so many bumps in the process and taken up so much of our time,” Heaton said. …

Iowa Democratic gubernatorial candidates ready to reverse Medicaid privatization
Source: Paige Godden, Des Moines Register, April 11, 2018
 
Six Democrats in the running to be Iowa’s next governor made it seem as though nearly all the state’s problems could be solved by reversing Medicaid privatization during a recent forum hosted at Simpson College. Candidates were asked questions ranging from how they’d help veterans to how they’d save rural Iowa, and their answers kept circling back to Medicaid.…

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Does KanCare work? The state’s data is so bad, legislative auditors can’t tell

Source: Andy Marso, Kansas City Star, May 9, 2018
 
A debate has raged in Kansas for years over KanCare, the privatized Medicaid plan enacted by Sam Brownback in 2013. Brownback and his successor, Jeff Colyer, have touted the program as a tremendous success that has saved the state $1 billion while improving care for 400,000 low-income and disabled Kansans. Democrats, provider groups and people who care for disabled Kansans have said it’s rife with billing problems, secrecy and decisions based more on money than quality care. … After a year of work, those auditors recently released their determination: the state’s data is so bad, there’s no way to know. “These data issues limited our ability to conclude with certainty on KanCare’s effect on service use and limited our ability to interpret cost trends,” the auditors wrote. “More significantly, data reliability issues entirely prevented us from evaluating KanCare’s effect on beneficiaries’ health outcomes.” …

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Kansas lawmakers dispute over possible passing of current KanCare 2.0 plan
Source: Kate Inman, Four States, April 23, 2018
 
Some Kansas lawmakers say they’re frustrated the state could move forward with the current version of KanCare 2.0.  The KanCare Oversight Committee heard more than five hours of testimony today from dozens of groups and people calling on the state to not move forward with KanCare 2.0. KanCare is the state’s privatized medicaid program.   During the committee meeting, some lawmakers wanted to revoke the panel’s previous support for Governor Colyer’s plan for KanCare 2.0. Under his plan, the state would implement work requirements and other eligibility rules.  The committee chairman says there isn’t enough time for lawmakers to recommend changes to KanCare 2.0 while others say it’s their job. …

Kansas gives Medicaid contractor until June 1 to improve
Source: Associated Press, February 17, 2018
 
The company processing Medicaid applications in Kansas faces fines of up to $250,000 a day and the loss of its state contract because it is far out of compliance with the required performance standards.  The Wichita Eagle reports that state sent Maximus a noncompliance letter Jan. 30 that gives the Virginia-based company until June 1 to fix problems that include only 40 percent accuracy on financial payments. State Medicaid Director Jon Hamdorf disclosed the action during a meeting of a legislative oversight committee Friday.  If the company fails to shape up, it could face fines retroactive to the beginning of the year, possibly totaling tens of millions of dollars. …

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Huge federal contractor ‘failed’ to pay workers $100 million in wages, union says

Source: Danielle Paquette, Washington Post, April 23, 2018
 
One of the country’s largest federal contractors has been accused of underpaying about 10,000 workers who run help hotlines for public health insurance programs, including the Affordable Care Act marketplaces, by up to $100 million over the past five years, according to four complaints filed Monday to the Labor Department.  The complaint brought by the Communications Workers of America alleges that General Dynamics Information Technology misclassified employees at call centers in Kentucky, Florida, Arizona and Texas to suppress their wages.  The union, which does not represent the workers, said the contractor hired or promoted workers into roles that require special training but paid them below government-set rates for the jobs they performed. The complaint covers the period since 2013, when GDIT started a $4 billion, 10-year contract with the Centers for Medicare and Medicaid Services. …

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Contractor that handles public’s Medicare queries will do same for Affordable Care Act
Source: Susan Jaffe, Washington Post, June 20, 2013

Within days, the company that handles a daily average of more than 60,000 calls about Medicare will be deluged by new inquiries about health insurance under the Affordable Care Act. The six Medicare call centers run by Vangent, a company based in Arlington County, will answer questions about the health-care law from the 34 states that opted out of running their own online health insurance marketplaces or decided to operate them jointly with the federal government. ….. Running the 800-Medicare call centers may provide valuable experience, but Vangent’s track record reveals that it was slow to adapt when changes in the Medicare program caused dramatic spikes in demand. ….. Vangent, a subsidiary of General Dynamics Information Technology, will run both Medicare and the federal health exchange call centers under a contract worth $530 million in its first year.

LePage Administration Outsources Part of Medicaid Program

Source: Associated Press, March 3, 2018
 
Republican Gov. Paul LePage’s plan to outsource part of the state’s Medicaid application process will cost the state more. The Bangor Daily News reports that the LePage administration acknowledges in a publicly posted contract document that there will be a “slight increase in cost.” The Maine Department of Health and Human Services in June will eliminate the positions of 10 state employees and enter into a $5.6 million, 25-month contract with a division of the University of Massachusetts Medical School. The agency didn’t respond to request for comment. …

Editorial: Self-dealing by nursing home owners threatens patient care

Source: Editorial Board, St. Louis Post-Dispatch, January 14, 2018

The outsourcing of logistical support services, which became commonplace in the U.S. military in the 1990s and later was adopted by state prison systems, has now come to dominate the nursing home industry. And while nursing homes, unlike the military or prisons, are not part of federal or state governments, Medicaid pays for the care of 62 percent of all nursing home patients, amounting to $55 billion in 2015. … In a remarkable story published Dec. 31, Kaiser Health News reported that the owners of nearly three-quarters of the 15,600 nursing homes in the United States buy a wide variety of goods and services from companies in which they have a financial interest or control. Nursing home owners can rent the land to themselves at above-market rates, or own the staffing company that provides nursing care and management. These business dealings, known as related-party transactions, offer efficiencies that can hold down costs and help minimize taxes. … In the nursing home industry, however, with its reliance on taxpayer dollars, related-party transactions can also encourage insider dealing, maximizing profits for the outside vendors while siphoning off funds needed for patient care and staffing. If a nursing home gives a no-bid contract for, say, linen services, to a firm controlled by the nursing home’s owners, it often pays inflated prices. … For nursing home owners, a complex web of related-party transactions can offer a shield against lawsuits or governments seeking restitution for Medicaid overpayments. This is outrageous. …

Exclusive: Nursing Home Sought Help From Lobbyist Friend Of Governor

Source: Jim Defede, CBS Miami, November 3, 2017

State officials intended to permanently shut down the now infamous The Rehabilitation Center at Hollywood Hills in 2014, when a lobbyist with deep ties to Governor Rick Scott interceded on behalf of the man who wanted to take it over, CBS4 News has learned. The role of one of the Governor’s friends lobbying state officials on behalf of Dr. Jack Michel so Michel could obtain the license for the Hollywood Hills nursing home has not been previously reported. The nursing home is now drawing intense scrutiny following the deaths of more than a dozen residents after its air conditioning system lost power during Hurricane Irma. … In 2014, Michel wanted to buy the nursing home, whose owner at the time, Karen Kallen-Zury, had just been convicted of Medicare fraud and was sentenced to 25 years in prison. … Political leaders have questioned whether Michel should have been granted a license given the fact that Michel and two former business partners paid $15.4 million to the federal government to settle fraud claims. …

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Hollywood nursing home should never have been licensed, state senator says
Source: Bob Norman, Local 10 News, October 26, 2017

The U.S. Justice Department hit Michel with civil Medicare fraud charges in 2004, alleging he received $70,000 each month in kickbacks to funnel nursing home patients into Larkin Community Hospital in South Miami for medically unnecessary procedures. … Michel eventually purchased the Larkin hospital (beginning with what the feds alleged appeared to be sham transactions) and, according to the complaint, began paying to other doctors for more bogus Medicare referrals. … Farmer says the fraud described in the Michel complaint has become all too common. … Michel and his business partners — including Chicago Rabbi Morris Esformes and his son, Philip — paid $15.4 million to settle the fraud case while admitting no wrongdoing. Published reports show that the Esformeses have a long history of nursing home violations going back decades in Chicago and other cities, including one case in 2001 involving the deaths of four women during a heat wave in St. Louis. Criminal investigations netted no charges in that case, but the nursing home was hit with a $275,000 civil judgment in one suit while three others ended with undisclosed settlements. But after paying the $15.4 million settlement to the federal government, both Michel and the Esformeses simply continued in the business of running nursing homes and hospitals. …

Hurricane Irma: Hospital linked to nursing-home deaths was paid $48M to care for Florida prisoners
Source: Arek L Sarkissian, Naples Daily News, September 26, 2017

The owner of a Florida nursing home whose 11 residents died after Hurricane Irma has benefited for years from millions of dollars in government contracts despite repeatedly running afoul of state and federal regulators. Dr. Jack Michel, owner of Rehabilitation Center at Hollywood Hills, owns a Miami hospital that has received $48 million in taxpayer money since 2006 to treat state prisoners. The payments to Larkin Community Hospital started the same year Michel settled a federal fraud lawsuit that accused him of bilking taxpayers. They continued after the state barred one of his assisted-living homes from taking new patients. And state officials are giving no indication that the payments will stop now despite Florida Gov. Rick Scott’s comments that the owner is unfit to care for patients after deaths at his nursing home.

Larkin provides the prison hospital care under no-bid agreements that the Florida Department of Corrections approved, according to agency contract and finance records. The hospital has served as a subcontractor to the state’s prison health care vendors with approval from corrections officials. Eight elderly patients died Sept. 13 after Irma knocked out power at Michel’s nursing home and residents remained for several days without air conditioning. Three other patients died days later after being hospitalized with complications. …

County services for disabled moving to private providers

Source: Rita Price, Columbus Dispatch, October 30, 2017
 
Federal rule changes about case management and Medicaid payments are forcing county disabilities boards throughout the state to privatize and outsource many of their remaining programs. The Centers for Medicare and Medicaid Services has mandated “conflict-free case management” by 2024 in Ohio, which means counties cannot be both the coordinator and the provider of services paid with Medicaid waiver funds.  But county boards still must pay for services and put up the local share of the Medicaid match — in Franklin County, more than $60 million a year for adult waiver services. Medicaid waivers provide money for community-based services so that people don’t have to be in an institution to get the care and programs they need. … Some 300 members of the county’s adult-services staff are to become ARC Industries employees in January 2019. … ARC is the disabilities program that provides job training, workshop employment, transportation and other services. Although ARC already was a nonprofit employer for people with disabilities, the workshops and programs have been staffed by county employees. Early childhood and school programs can continue to be operated by the board because they’re not funded through Medicaid waivers. … Initially, Morison said, the board’s costs might increase as a new infrastructure is established. He expects it to even out in coming years. …

Consultant: BRF lacks cash, experience to adequately manage hospitals

Source: KTBS, October 10, 2017
 
Biomedical Research Foundation’s lack of cash could cause the state to lose funding for free and low-cost health care at the former public hospitals the foundation operates in Shreveport and Monroe.  Documents obtained by KTBS through an open records request show state officials are concerned the hospitals could lose Medicaid funding. That federal money helps cover the cost of treating poor people without insurance at the hospitals BRF operates as University Health through a wholly-owned subsidiary.  In September, state officials put BRF on notice it had breached its contract to operate the hospitals, in part because BRF has failed to pay doctors at LSU Medical School in Shreveport for treating patients. BRF also owes the state for a lease on the hospital property. …

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$135M boost going to LSU hospital managers under new deals
Source: Melinda Deslatte, Associated Press, October 27, 2016

The private operators of LSU’s charity hospitals and clinics are in line for a $135 million boost in their payments as part of new deals struck by Gov. John Bel Edwards’ administration, and the university’s medical schools will benefit from some of the new money. State lawmakers are being asked Friday to increase financing for the privatization deals to nearly $1.3 billion in the current budget year, only four months after lawmakers were told the previous level of funding was sufficient. … The money for the hospital and clinic operators is part of a larger budget adjustment requested by the Louisiana Department of Health at Friday’s meeting of the joint House and Senate budget committee. Jeff Reynolds, chief financial officer for the health department, said $135 million is a financing increase for the private managers that have taken over LSU’s hospitals, clinics and patient services. He said the additional payments are part of the renegotiated deals recently worked out by the Edwards administration. … The renegotiated privatization deals crafted by the Edwards administration included provisions in which some of the hospitals will be paying more money for the services of LSU’s doctors who work at the hospitals. … Henry said he wanted to know why the dollars weren’t available when lawmakers were crafting the budget in June, when they were told the previous level of agreed-upon financing was sufficient for the privatization agreements. …

Negotiating over, Edwards makes offers on LSU hospital deals
Source: Melinda Deslatte, Associated Press, September 7, 2016

Gov. John Bel Edwards’ administration will make its offer Thursday to the operator of LSU’s hospitals in Shreveport and Monroe for a renegotiated contract with the state, as the governor pushes to rewrite all the LSU hospital privatization deals. Edwards’ lead negotiator on the contracts, Commissioner of Administration Jay Dardenne, said Thursday’s presentation to the Biomedical Research Foundation of Northwest Louisiana is the last offer to be made. … Dardenne wouldn’t provide details about what changes are being sought in the north Louisiana hospitals’ deal — or any others. But he said negotiations are over and hospital operators can either take or leave the reworked arrangements offered. … Former Gov. Bobby Jindal privatized nine LSU-run hospitals and their clinics through no-bid contracts, with the earliest deal starting in April 2013. In most instances, the management company of a nearby hospital took over operations. Three contracts closed an LSU hospital — in Baton Rouge, Lake Charles and Pineville — and shifted its services to private hospitals. The Edwards administration says the deals were too hastily slapped together, with terms that aren’t favorable to the state. … LSU System President F. King Alexander described the arrangement to have the foundation, known as BRF, run the Monroe and Shreveport hospitals as dysfunctional from its start in October 2013. Alexander said the research foundation, which runs the two hospitals as the University Health System, doesn’t have the resources or experience, isn’t paying bills on time and isn’t providing enough support to the LSU medical school in Shreveport. BRF and University Health leaders say Alexander’s accusations are untrue and LSU’s Shreveport medical school has financial problems of its own making. They say the research foundation’s hospital management has improved health care. …

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Judge: IBM Owes Indiana $78M For Failed Welfare Automation

Source: Associated Press, August 7, 2017

A judge has ruled that IBM Corp. owes Indiana $78 million in damages stemming from the company’s failed effort to automate much of the state’s welfare services. … Indiana and IBM sued each other in 2010 after then-Gov. Mitch Daniels cancelled the company’s $1.3 billion contract to privatize and automate the processing of Indiana’s welfare applications following numerous complaints. The Indiana Supreme Court ruled last year that IBM breached its contract. The justices affirmed a lower court’s award of nearly $50 million to IBM in state fees, but that ruling allowed Indiana to seek more than $172 million in damages from IBM.

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IBM contests judge’s removal petition in welfare-privatization suit
Source: Dave Stafford, Indiana Lawyer, May 25, 2016

The state’s petition to remove a trial court judge who oversaw the civil lawsuit over the canceled $1.3 billion contract with IBM to overhaul Indiana’s welfare system is “factually incorrect,” according to an attorney representing IBM. Andrew Hull of Hoover Hull Turner LLP said in a statement that Marion Superior Judge David Dreyer did nothing to merit removal and didn’t violate Indiana Trial or Appellate Rules in an order issued on remand from the Indiana Supreme Court, as Barnes & Thornburg LLP lawyers representing the state argued in briefs filed Monday. Their petitions and brief seeking writs from the Supreme Court argue Dreyer overstepped his authority by issuing the order without proceedings, called into question his impartiality in the matter, and asked the court to vacate his order on remand and bar him from issuing further orders in the case.

Indiana Seeks New Judge After No Damages Awarded in IBM Case
Source: Rick Callahan, Associated Press, May 10, 2016

Attorneys for the state are challenging a judge’s decision not to award Indiana damages in its long-running fight with IBM Corp. over the company’s failed effort to privatize state welfare services, saying a new judge should be appointed to handle the case. The Indiana Supreme Court ruled in March that IBM had breached its $1.3 billion contract to automate much of Indiana’s welfare system. The high court directed the trial court judge to determine what damages IBM owed the state, opening the door for Indiana to seek up to $175 million. But on Friday, that judge, Marion County Superior Court Judge David Dreyer, ruled that “the costs for which the State seeks reimbursement were not adequately proven, and thus cannot be recovered as damages.” The state’s private attorneys in the case quickly filed a motion seeking a new judge to oversee the case. … The resulting lawsuits between Indiana and IBM were assigned to Dreyer, who found in 2012 that Indiana had failed to prove IBM breached its state contract and awarded the New York-based company about $50 million in state fees. Indiana appealed that ruling, and the state Court of Appeals found in February 2014 that IBM had committed a material breach of its contract by failing to deliver improvements to the state’s welfare system. But it also found IBM was entitled to nearly $50 million in state fees.

Mediation coming in IBM, Indiana contract dispute
Source: Associated Press, December 10, 2014

IBM Corp. and the state of Indiana are turning to mediation in hopes of settling their dispute over IBM’s failed attempt to privatize Indiana’s welfare services. The two parties said in a Monday court filing with the Indiana Supreme Court that they have agreed to mediation and chosen John R. Van Winkle of Indianapolis-based Van Winkle-Baten Dispute Resolution to hear their differences at a Feb. 25 mediation session. The state Supreme Court heard oral arguments in the welfare-privatization contract dispute on Oct. 30. The following week, Chief Justice Loretta Rush suggested that the parties consider mediation “to seek a mutually agreeable resolution of their dispute.” Rush’s order also said that if mediation failed, the court would move ahead to reach a decision in the long-running dispute.

Appeal of IBM-deal fees heard
Source: Niki Kelly, Journal Gazette, November 26, 2013

The fallout from the failed $1.3 billion IBM welfare modernization contract continued Monday as the Indiana Court of Appeals heard arguments over $100 million in disputed fees. … Attorney Peter Rusthoven, representing the state, said the system was plagued with problems from the outset and IBM refused to hire more people to add to the “human dimension.” …. But attorney Jay Lefkowitz, on behalf of IBM, pointed out that Indiana was trying to hire IBM to run the new hybrid system up until the day the company was terminated.

IBM, state in court Monday
Source: Tim Evans, Indianapolis Star, November 20, 2013

The Indiana Court of Appeals will hear oral arguments Monday in the legal battle over a $52 million judgment the state has been ordered to pay IBM over the failed attempt to privatize public welfare services under former Gov. Mitch Daniels. …. The state is appealing a Marion Superior Court judge’s 2012 ruling awarding $52 million to IBM after the state canceled a contract Daniels had hailed in 2006 as the solution for fixing one of the nation’s worst welfare systems. …. “Neither party deserves to win this case,” he wrote in his 65-page ruling. “This story represents a ‘perfect storm’ of misguided government policy and overzealous corporate ambition. Overall, both parties are to blame, and Indiana’s taxpayers are left as apparent losers.”

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Part of food stamp website offline for two weeks
Source: Tony Cook, Indianapolis Star, November 6, 2013

Earlier this year, state contractor RCR Technology wrongly released the private information of Indiana welfare recipients. Now, part of the state’s benefits website administered by the company is broken. …. The problems come just four months after revelations that RCR wrongly revealed private data of FSSA clients, including Social Security numbers. … RCR was initially an FSSA subcontractor, but was later elevated to prime contractor after Gov. Mitch Daniels fired IBM over a botched 10-year, $1.37 billion deal to overhaul the state’s welfare system, Gavin said.

Ind. court sets hearing on IBM welfare lawsuit
Source: Associated Press, September 3, 2013

The Indiana Court of Appeals has set a November hearing in the state’s legal fight with IBM Corp. over a failed attempt to overhaul Indiana’s welfare system. The state is appealing a Marion County judge’s ruling last year awarding $52 million to IBM after then-Gov. Mitch Daniels canceled what was a 10-year, $1.37 billion contract to process applications for food stamps, Medicaid and other programs….

The Unequal State of America: Indiana’s rocky road to welfare reform
Source: David Rohde and Kristina Cooke, Reuters, December 20, 2012

In 2006, Gov. Mitch Daniels privatized the management of the welfare-benefits system with a project led by IBM. Two-thirds of Indiana’s social-service agency’s staffers became employees of IBM and its partners. In a process dubbed “welfare modernization,” recipients would apply for benefits online and by phone rather than meeting social workers face to face. It was, by Daniels’s own admission, a failure…..

JEditorial: Human toll of FSSA deal laid bare
Source: Journal Gazette, July 24, 2012

Editorial: Decision to privatize state welfare system a mistake from start
Source: Evansville Courier & Press, July 22, 2012

Judge denies Indiana claim over failed IBM project
Source: Charles Wilson, Associated Press, July 18, 2012

A judge on Wednesday spurned Indiana’s efforts to recoup roughly $170 million from IBM Corp. over its failed effort to overhaul the state’s welfare system as part of a broader privatization push that was an early hallmark of Republican Gov. Mitch Daniels’ tenure. Marion County Judge David Dreyer said in a 75-page order that neither side deserved to win the dispute, and awarded IBM only a small fraction of what it was seeking. … Dreyer blamed “misguided government policy and overzealous corporate ambition” for the failure of the system, which he called an “untested theoretical experiment.” … Dreyer said Indiana failed to prove that IBM breached its contract, and he denied the state any of the money it sought.

IBM questions Daniels’ resistance to deposition
Source: Carrie Ritchie, IndyStar.com, December 19, 2011

In court, state and IBM spar over welfare system’s design
Source: Carrie Ritchie, Indianapolis Star, March 9, 2012

IBM to begin making case in welfare trial
Source: Indianapolis Star, March 21, 2012

IBM: Indiana canceled deal because of budget woes
Source: Associated Press, April 3, 2012

IBM, state in final arguments at welfare system trial
Source: Carrie Ritchie, Indianapolis Star, April 3, 2012

Judge orders Gov. Daniels be deposed in IBM lawsuits
Source: Carrie Ritchie, IndyStar.com, December 16, 2011

A judge has ordered Gov. Mitch Daniels to share his knowledge of a canceled $1 billion contract with IBM to help resolve a legal battle between the state and the company.

Attorneys for the state had said a law protects Daniels and other high-ranking state officials from testifying….

Michigan begins to design 4 pilot projects to test mental health integration

Source: Jay Greene, Crain’s Detroit Business, August 4, 2017

What is going on at the Michigan health department about designing four pilot programs to test a controversial plan to combine physical and behavioral Medicaid services among mental health agencies, providers and HMOs? So far, nothing, at least on the selection and design of the pilots. … Section 298 is a controversial budget section that, under Snyder’s original plan put forth in early 2016, would have allowed some of the state’s health plans to manage the $2.6 billion Medicaid behavioral health system. The Medicaid HMOs already manage a nearly $9 billion physical health system. Over the past two years, Michigan’s 11 Medicaid health plans have lobbied legislators and the public to try a semi-privatized approach under Snyder’s plan, which was finally approved in June. … Republicans in Michigan want to test the concept in four pilot projects that everyone believes will be Kent County, an urban area like metro Detroit, a northern Michigan rural area and in western Michigan, which could include Kalamazoo County, sources tell me. Lori said the state has not received any formal suggestions for where the four pilots would be located. …

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Plan to privatize Mich. mental health aid advances
Source: Karen Bouffard, Detroit News, June 20, 2017
 
The first step in a plan to turn control of Michigan’s $2.6 billion mental health budget over to privately owned insurance companies is poised for inclusion in next year’s state budget, despite a wall of opposition from mental health providers, patients and families across Michigan.  The contentious plan is embedded in two provisions of the state budget for the Department of Health and Human Services, part of the Omnibus Budget bill approved by the state House on Tuesday expected to be approved by the state Senate on Thursday. …

Lobbying ramp-up precedes mental health funding proposal
Source: Justin A. Hinkley, Lansing State Journal, April 27, 2017

Physical health insurers ramped up lobbying operations and far out-spent their behavioral health counterparts in the months before lawmakers pulled an about-face on who should manage billions of Medicaid dollars for mental health services. Community mental health groups and allied advocacy groups spent about $52,400 on lobbying in 2016, nearly $8,700 more than their average from the previous three years, state records show. That happened as they fought to maintain management of Medicaid money for behavioral health. However, lobbyists for the private insurers who currently manage Medicaid dollars for physical health spent a combined nearly $838,000 last year, about $21,000 more than their previous three years’ average as they seek to take over the mental health dollars. … That ramp-up happened as lawmakers and Gov. Rick Snyder’s administration changed positions on the Medicaid issue — to the benefit of the physical health insurers. In February 2016, Snyder called for the private health management organizations who oversee physical health spending to also take over mental health money by Oct. 1, 2016. Lawmakers denied that proposal and instead asked the administration to study the issue and make recommendations by spring 2017. The administration did that last month, changing its position from 2016 and calling for the two funds to remain under separate management. Last week, however, lawmakers in the Senate advanced a budget proposal that would give the mental health money to HMOs by 2020. …

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