Monday Morning Medicaid Must Reads: July 8th, 2019

Helping you consider differing viewpoints. Before it’s illegal.
other MMRS –

In this issue…

Article 1:       Wayne State generated $112.8 million a year in enhanced Medicaid funding over six years

Clay’s summary:     You can make a lot of money in the Medicaid financing shell game. A lot. Cue outrage from Medicaid lifers who swear IGTs, CPEs, etc are not a scam.
Key Excerpts from the Article:
PEPPAP was designed for Michigan in 2004 as a federal-state Medicaid matching program to give payment add-ons to doctors that would increase their reimbursements to Medicare-equivalent levels. Many states have variations of the program, but all are designed to encourage providers to increase access to care for poor people on Medicaid.
But in order to receive the funds, Wayne State is required under the program to send to the state Department of Health and Human Services matching funds that averaged $32.2 million per year. On a quarterly basis, MDHHS calculates the state-federal match and sends the university a check.
Besides Wayne State, which is considered a “public entity” under the Medicaid state plan amendment rules, there are six others receiving PEPPAP funds in Michigan. They are Michigan State University, Central Michigan University, Oakland University, University of Michigan, Western Michigan University and Hurley Medical Center, the only publicly owned hospital in Michigan, in Flint.
Read full article in packet or at links provided

Article 2:       Letters: Time to ask tough questions about Louisiana Medicaid, The Advocate (Baton Rouge)

Clay’s summary:    Ruh-roh. Someone’s noticing things. Things that make Medicaid expansion look bad. Look- a squirrel!
Key Excerpts from the Article:
From the beginning, Louisiana’s conservative legislators have simply asked that Medicaid expansion serve those most in need. Since then, scathing report after report has revealed that this was not the intention of this administration. The Pelican Institute recently revealed in a report that thousands of individuals per month are dropping their private insurance plans to join the taxpayer-funded program. What’s worse, there are more than 1,000 individuals enrolled in Medicaid who earn annual salaries of $100,000 or more. Medicaid expansion’s original intention was to help those who needed it most, but those are the ones greatest impacted as we expand eligibility while providers shrink.
Read full article in packet or at links provided

Article 3:      Tennesseans Losing Medicaid; State Hasn’t Bounced Back from Software Failure

Clay’s summary:     Advocates concerned over declines in Medicaid rolls point to a software issue that happened in 2013.
Key Excerpts from the Article:
Tennessee is one of three states in the country with the sharpest drop in Medicaid enrollment between 2017 and 2018.
According to a report by the consumer health care group Families USA, the number of Tennesseans enrolled in Medicaid fell by nearly 10%, and more than 100,000 people lost coverage.
Eliot Fishman, senior director of health policy at Families USA, says that since 2013 the state has been struggling to bounce back from a massive software failure linked to TennCare, the state’s Medicaid program.
Read full article in packet or at links provided