Thursday, February 10, 2011

State Medicaid Cutbacks?

Medicaid is a rapidly growing sector of the health care arena.  Today, 50 million low income people receive health benefits from their State Medicaid program.  The 50 million individuals are comprised of adults, large numbers of seniors and disabled patients in nursing homes, and 1 in 4 children in America.

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Medicaid costs are the top expense of most state’s budget. With this in mind, states have asked HHS, Kathleen Sebelius for help. The states have requested to reduce enrollment within their respective states and raise eligibility criteria to foster this reduction. Another aspect of this request is their revenue shortfall of $175 billion. With the current administrations stimulus bill drying up at the end of this year all states are scrambling to find ways to survive.  The easy state budget cuts have been made and now hard realities must be reviewed. To make up this difference the states have asked to cut Medicaid enrollment and reduce eligibility. Currently each state much maintain a Medicaid enrollment level.

Secretary Sebelius urged states to find savings through other approaches, including charging higher co-payments for some services, limiting certain benefits, managing high-cost patients more efficiently, squeezing drugs costs, and cracking down on improper payments.

"We are committed to responsiveness and flexibility, and will expedite review of state proposals," Sebelius wrote. "My team stands ready to come to your state to discuss your priorities and how we can help achieve them."


Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. Pam can be contacted at

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