Medicaid cost & Caseload

Adds $4.3M to Medicaid

Adds $8.3M

Medicaid Provider Rates

Add $12.9M:

ü      2% incr. to MCOs ($9.9M)

ü      2% incr.to Chronic Disease Hosp ($1M)

ü      IMCF for MR 5% incr. ($2.1M)

Same as Governor

Other Provider Rates

ü      FQHC no additional dollars

ü      SBHC  5% decr.

ü      Healthy Start (-$63,045) FY 04 annualized reduction recisions 12/03

ü      Medicaid Hosp. rates incr. with revised base discharge rate start 10/1/04

ü      Residential care homes; rate freeze

ü      NP provider COLA at 1%

ü      Pharmacies: Medicaid/ConnPace dispensing fee decr. to $3.00/script

ü      Incr. $1.1M under Medicaid

ü      $363,386 restored to SBHC (DPH)

ü      Healthy Start: same as Gov.

ü      Hosp. rates, Cmte concurs, but assumes rate implementation start date 1/1/05

ü      FY05 – 1.5% rate increase

ü      CMTE added 0.5% for total 1.5% 10/1/04

ü      Reduce Dispensing Fee to $3.15/script

Community Health Initiatives - DSS

No change to funding of various programs

Added $1M for:

·         $50,000 Housing/Homeless

·         $200,000 homeless shelters

·         $100,000 Homes for the Brave

·         $100,000 Children’s Health Council

·         $200,000 CAUSA

·         $100,000 augment Hartfd teen pregnancy prevention efforts

DSS Human Service Infrastructure (HIS) Community Action Program

$2,641,956

Same as the Governor.

Statewide on-line Medicaid/HUSKY application program

Carry forward of $200,000 to be available for Medicaid management information system and on-line program

Programs

Medicaid non-emergency adult dental services

Eliminate non-critical dental services for FY05 savings of $4.7M with $1M transfer DMR

CMTE does not concur with this plan

$2 non-emergency transportation co-pay

Mandatory $2 co-pay with FY05 $1.23M savings

CMTE does not concur with Medicaid co-pay

HUSKY A Benefit Package

& Medicaid FFS cost sharing

FY04-05:

ü      Restructure benefits similar to State Employee Non-Gatekeeper Point of Enrollment plan.

ü      Medically needy monthly premiums

CMTE provides $17.7M to:

ü      Restore HUSKY A benefit package

ü      Eliminate monthly premiums for Medicaid FFS

Medicaid Co-Pays

FY04-05 Medicaid adult co-pays for pharmacy (>$1.50) & OP visits (new $2)

CMTE provides $14.2M to eliminate co-pays under Medicaid program

HUSKY B resources

ü      Incr. HUSKY B resources -$328,335

ü      HUSKY Plus expenditures broken out into a separate account

Same as Governor.

HUSKY: child support & TPL claims

DSS incr. ID of child support cases for 3^rd party liability claims: estimate 2,000 cases, with net savings of $1.9M

Same as Governor.

Behavioral Health Partnership

ü      Reallocate a total of $120.4M from Medicaid & HUSKY accts. to new BHP

ü      $500,000 transfer from SAGA to DMHAS

ü      CMTE does not alter current account structure  (BHP).

ü      Concurs with technical transfer to DMHAS

Restructure Pharmacy services in Medicaid Managed Care

Consolidate management of Medicaid MC pharmacy under a single entity- formulary, savings $2M

Same as Governor

Legal Immigrant Benefits

2003 legislation: DSS no longer providing legal immigrant state benefits.

CMTE provides $2.5M to continue various state benefits

Child Care Enrollment

Additional $12M over current funding ($6M GF, $6M TANF high performance bonus) to serve 1,800 additional families

CMTE concurs with Gov. and provides $10.7M for additional 2,200 slots =  Total 5,000 new slots

ConnPace

ü      Fund $11.1M to reflect caseload & cost trends

ü      Repeal estate recovery ($250,000)

ü      Liquid asset test limit $100,000single, 125,000 couple

ü      Fund $10.1M

ü      Same as Governor

ü      Provide $1.25M to repeal this asset limits

State Assistance (SAGA)

ü      Incr. $9M to reflect higher expenditures in pharmacy as less savings under FQHC 340b discount program.

ü       Transfer of assets penalty - 3-month look back. $19,000 savings

ü      CMTE assumes $9M adj., directs portion of  $ to eliminate SAGA med/script co-pays.

ü      CMTE does not concur with asset penalty