DHHS reviews options for Medicaid expansion

From the News & Observer:

RALEIGH, N.C. — North Carolina’s health secretary said Wednesday her agency is collecting information for Gov. Pat McCrory to offer him possible ways to expand Medicaid coverage to more people under the federal health care overhaul.

The Republican-led General Assembly and McCrory declined to accept expansion last year because they said the state Medicaid office consistently faced shortfalls in the hundreds of millions of dollars. A state audit and other troubled operations led McCrory to call the $13 billion program “broken.”

But Health and Human Services Secretary Dr. Aldona Wos told a legislative committee the agency’s financial and structural improvements make offering credible options doable.

“We are at a point …. where we have an ability to evaluate options for the state and will be presenting those options to the governor,” Wos told the Joint Legislative Program Evaluation Oversight Committee. Last week, Wos trumpeted to another General Assembly panel how the Division of Medical Assistance held a $64 million cash balance at the end of the last fiscal year.

Wos stressed it would be up to others to decide on expansion, most of which would be paid by the federal government for the near future. Expansion is designed for hundreds of thousands of uninsured North Carolina residents who make too much for traditional Medicaid but not enough for subsidized insurance exchange plans. Medicaid currently enrolls more than 1.8 million state residents — mostly poor children, older adults and the disabled.

Wos gave no timetable for offering McCrory those options but said it would be more than just determining whether it would make financial sense. For example, she said, there needs to be enough health care providers to oversee any wave of new enrollees.

McCrory said in July he would be willing to revisit Medicaid expansion if cost overruns were repaired and provided the federal government in part gave the state flexibility to target any coverage increase based on North Carolina’s needs.

Earlier Wednesday, DHHS also announced plans for a retooled organizational structure for the division, the first of its kind in 36 years. It shifts from two division sections to what the agency calls five clearly defined functions. An outside consultant has been helping with organizational, finance and budget forecasting within Medicaid.

Again Wednesday, Wos rejected arguments from the legislature, particularly the Senate, to remove Medicaid from DHHS, saying it would undo recent progress.

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on September 18, 2014, in Accountable Care Organizations, Aldona Wos, DHHS, Division of Medical Assistance, General Assembly, Gov. Pat McCrory, Health Care Providers and Services, Joint Legislative Oversight Committee on Health and Human Services, Legislation, Managed Care, McCrory, MCO, Media, Medicaid, Medicaid Attorney, Medicaid Budget, Medicaid Providers, Medicaid Recipients, Medicaid Reform, NC, North Carolina, State Budget, State Plan, Taxes, Taxpayers, Wos and tagged , , , , , , , , , , , , , , , , , , . Bookmark the permalink. 3 Comments.

  1. One has to wonder what portion of that DMA “cash balance” was delayed or withheld payments to providers.

  2. This is how you get a budget surplus. Don’t pay providers. Budget overruns. You mean claims from providers. Anyone see the trend here.

  3. If it is true that one of the criteria for Medicaid expansion is having enough providers to handle the increased workload, and if DHHS succeeds in retroactively recouping the 3% reimbursement reduction back to Jan. 2014, I think they will have a lot more trouble finding enough providers willing to see the patients. Pay me today, then you might take it back next month? I don’t think so.

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