The following summarizes news coverage of recent Medicaid developments in Florida, Idaho, Illinois, Tennesse and West Virginia.

Florida: An assortment of 84 social-service, health care and senior groups on Monday voiced opposition to Florida lawmakers over the planned overhaul of the state's Medicaid program, which would place more beneficiaries in managed care plans and cap per-beneficiary state expenditures to help reduce costs, the Tallahassee Democrat reports. Advocates for people with disabilities, seniors and the poor said not enough information is known about how managed care companies could "squeeze treatments to sick and disabled patients," the Democrat reports. They also said there are not enough cash incentives to attract managed care companies into the plan. In addition, they argued that if HMOs cut optional mental health treatments, more beneficiaries could be institutionalized, and that hospitals treating the uninsured could become overwhelmed (Deslatte, Tallahassee Democrat, 11/8).

Idaho: Key state lawmakers are welcoming the plan proposed by Gov. Dirk Kempthorne (R) to reform the state's Medicaid system, the Idaho Statesman reports. The plan calls for Medicaid to be split into three plans -- one for healthy children and adults, one for people with disabilities and one for the elderly. The plan might have different goals for each group, possibly integrating healthy beneficiaries into the private health care market, but encouraging supported independence for people with disabilities, state Rep. Kathie Garrett (R) said. State Sen. Dean Cameron (R), co-chair of the state Senate Budget Committee, said, "I think there's some potential for some immediate effect. But by and large, the majority of (potential cost savings) will be in the long run." Rep. Margaret Henbest (D) said the potential for cost savings comes from working with people to help "engage in healthy behaviors that will actually improve their health." She added, "At least we're moving in that direction, and that I totally applaud" (Hahn, Idaho Statesman, 10/30).

Illinois: Lawmakers in a bipartisan panel Thursday discovered that the state's recently approved $1 billion short-term loan to help pay off $1.35 billion in overdue Medicaid bills will help only in the short term, Copley News/Peoria Journal Star reports. The Medicaid backlog of payments is predicted to return to $1.8 billion by June 30, 2006, the end of the fiscal year. The short-term loan, which must be repaid by the end of the fiscal year and will attract $1 billion in federal matching funds, also will reduce the current payment delay to Medicaid health care providers from 66 to about 30 days. Eventually, the payment cycle will grow to 75 days, which was set during the 2004 budget negotiations (Massingale, Copley News/Peoria Journal Star, 11/4).

Tennessee: Gov. Phil Bredesen's (D) newly created Tennessee Office of Inspector General, which monitors fraud committed by TennCare beneficiaries, might cost more to operate than it saves through fraud detection, the AP/Tennessean reports. Beneficiaries who defraud TennCare often use the program to purchase and sell prescription drugs or misrepresent their identities or incomes to obtain free services. According to the AP/Tennessean, the office, which is independent of TennCare, costs $5 million a year to operate and is "nowhere near recouping that amount in restitutions from convictions" of TennCare beneficiaries. The restitution paid by most of the 26 people convicted of beneficiary fraud in the last year was a few thousand dollars. More than 100 other people have been arrested for suspected fraud so far, and many are awaiting indictment. According to David Himmelreich, the state OIG's deputy inspector general, the office's job is to investigate criminal activity, regardless of the savings to the state (AP/Tennessean, 11/7).

West Virginia: The West Virginia Department of Health and Human Resources recently opened 181 spaces in a Medicaid waiver program that waives Medicaid family income guidelines and offers services to more than 3,800 mentally retarded or developmentally disabled adults and children who otherwise would have to live in residential care, the AP/Charleston Daily Mail reports. The decision, which took place after a state audit of the program, will allow an additional 181 people on the program's waiting list to participate in the program, the AP/Daily Mail reports. Under a 2000 court order, approved applicants are supposed to begin receiving services within 90 days of approval, but after all of the program's slots are filled, applicants are put on a waiting list. According to the AP/Daily Mail, at the end of September, 231 people were on the program's waiting list. Tom Gillooly, legal director of West Virginia Advocates, said he has been talking to agency officials since February about the length of time people were on the waiting list. However, it was not clear why the audit was ordered, the AP/Daily Mail reports (Bundy, AP/Charleston Daily Mail, 11/4).


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