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Senate Passes Medicaid Budget Bill

The Kentucky Senate has approved its plan for balancing the state’s Medicaid budget.

The Senate vote was 22-15, along party lines, with Republicans voting Aye and Democrats voting Nay. On Monday, the House voted 94-4 for a different version of the bill, but there are some similarities. So now, House and Senate negotiators will try to reach a compromise. House Speaker Greg Stumbo says cuts to education in the Senate plan are a deal breaker.

“It’s unacceptable. We met with Representative Hoover and the Republican leadership and we all went through the bill and everyone agrees. It’s just the same old rhetoric,” he says.

But Senate President David Williams says, wait, let’s talk.

“I think that both sides continue to move, and we feel like we came a long way,” he says.

Looming over the heads of negotiators is the date April 1st. That’s when Gov. Steve Beshear says he will have to cut Medicaid provider reimbursement rates by 35 percent if lawmakers fail to reach an agreement.

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Medicaid Bill Action Still Pending

The first week of the special session on balancing Kentucky’s Medicaid budget is over. However, action on a Medicaid bill is still pending.

The House passed a bill this week raising the state’s drop out age, but the Medicaid bill still awaits a vote in the Appropriations and Revenue Committee. Three days of hearings have been held, but Speaker Greg Stumbo says the committee still wants to hear from Health and Family Services Secretary Janie Miller.

“We’ve asked her to be prepared to give us a pretty definite timetable about when they’ll know whether these cost saving measures truly are going to materialize and that those savings can be achieved.”

He’s referring to savings from Medicaid managed care anticipated by Gov. Beshear. Stumbo says the budget committee could vote on the Medicaid bill Monday or Tuesday, as the special session moves into a second week.

“I think that if we do come to some accord on some of the sticking points of this plan,” he says “that you will see a large majority of the members of the general assembly – both House and Senate members – who will believe that this is a fair and equitable plan.”

At least one more hearing will be held in the House Appropriations and Revenue Committee before a vote is taken on a Medicaid bill. Health and Family Services Secretary Janie Miller is scheduled to testify before the committee on Monday.

Kentucky Senate President David Williams is still grumbling about the pace of the special session. Williams says Gov. Beshear never should have called the session without some kind of an agreement.

“Then-candidate Beshear chastised Gov. Fletcher for calling the general assembly back in and wasting money before he reached a resolution to the problem,” syas Williams “and he’s turned around and done exactly the same thing.”

Gov. Beshear says he had no choice because lawmakers failed to fix Medicaid during the regular session, and if they can’t find a compromise, he will have to cut reimbursement rates to Medicaid providers by 35 percent on April 1st.

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Hearings on Kentucky Medicaid Budget Begin

Kentucky lawmakers continue their search for middle ground  on balancing the state’s medicaid budget.

Hearings on the Medicaid budget have begun in the House Appropriations and Revenue Committee.  Some Medicaid providers, particularly rural hospitals and pharmacies, say 35 percent cuts in reimbursement rates would be devastating.  That’s the amount Gov. Beshear says he must cut on April 1st if lawmakers fail to reach agreement on a Medicaid fix.  Rep. Rick Rand chairs the budget committee.  

“We have some more people to talk about Medicaid and what would happen if we leave here without reaching a compromise,” says Rand “and from there, then we’ll talk to some of the agencies on how these proposed budget cuts will affect them.”

Senate Republicans want to balance Medicaid with across-the-board cuts to state agencies, including education.  Gov. Beshear says he can balance the program without cuts.  House Speaker Greg Stumbo says he and House Minority Leader Jeffrey Hoover are discussing a bipartisan compromise that would target areas, besides education, to cut in case deficits occurred under the governor’s plan.

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Beshear Calls Special Session

Gov. Steve Beshear is calling a special session of the Kentucky General Assembly that will have a limited agenda.

After the Senate gaveled in on the 30th day of the regular session, effectively ending the session early, Gov. Beshear announced the session, which starts Monday. Only two items will be on the agenda.

“The first is reopening the budget to balance Medicaid, and to fulfill maintenance of effort requirements under the 2010 Education, Jobs and Medicaid Assistance Act, which will require a minor shift of higher education funds. The second agenda item is enacting legislation to increase the dropout age at our schools.”

Both issues failed to win final passage in the regular session. Standing with the governor during his news conference were House leaders and several Senate Democrats. There was no immediate response to the governor’s comments from Senate Republicans.

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Talks on Medicaid Budget Continue in Frankfort

Senate President David Williams says he’s keeping an open mind as negotiations on the Medicaid budget resume this morning in Frankfort. Negotiators met briefly Friday evening and agreed they don’t see eye to eye, but Williams isn’t ruling out compromise.

“Hope springs eternal. The bottom line is, the governor’s proposal is without merit. Everyone in the legislature knows that you cannot approach this thing the way the governor is approaching it,” says Williams.

Senate Minority Leader R-J Palmer is optimistic some kind of agreement will be reached.

“You know, I think we’ve shown plenty of times in the past that the two chambers have been pretty far apart at the beginning of a conference committee and they’ve been able to come to a resolution,” he says. “I think that this possibility exists for this as well.”

Governor Beshear and the Democratic-controlled House want to shift second year funds to the current year, to fill a huge hole in the Medicaid budget. Any second year deficits would be covered by savings from managed care. The Republican-controlled Senate prefers small, across-the-board cuts to state agencies, including education. Only three days remain in the 30-day session.

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In Frankfort, Talk of Special Session Begins

There’s now talk in Frankfort of a special session on Kentucky’s Medicaid budget.

Senate President David Williams says he’s willing to negotiate with the House on Medicaid, but if the talks don’t go anywhere, lawmakers may as well adjourn and go home. Then, if an agreement is reached later, it could be approved in a special session.

“If we came back on a Monday for a special session, we would use five days. That would save 13 days at about $68,000 a day,” he says.

But that idea does not sit well with House Speaker Greg Stumbo.

“If one believes you can accomplish in a special session what needs to be accomplished, why don’t you just do it now,” says Stumbo.

Balancing the Medicaid budget remains the last major issue still be resolved in the 2011 session, which is down to its last three days.

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Health Secretary Says Managed Care Will Keep Medicaid Budget Balanced

Kentucky Health and Family Services Secretary Janie Miller is confident managed care will produce enough savings to keep the state’s Medicaid budget balanced.

Miller says the proof can be found in other states with managed care programs.

“There are a number of studies out there that are independent studies that document managed care savings. So, they prove that they can save money, if they’re done properly. Percentage savings estimates vary according…I’ve found studies that range from one percent to 20 percent, depending on the population of the services managed and the areas of the state that they covered,” she says.

Governor Beshear wants to shift second-year funds forward to balance the Medicaid budget, and make up any second year deficits with savings from managed care. The Democratically-controlled House agrees with his plan, but the Republican-controlled Senate wants across-the-board cuts to state agencies, including education. House Republicans oppose cuts to education. The debate is dominating the waning days of the legislative session.

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Medicaid Funding Bill Clears House

Gov. Steve Beshear’s plan for balancing the state’s Medicaid budget has taken a giant step forward in the Kentucky General Assembly.

The House voted 80-19 to move 166-million dollars from the second year of the Medicaid budget, to the current year, to cover a large deficit.

All 19 opponents, including Rep. Stan Lee of Lexington, were Republicans. Lee said, “I think we need to be cautious. I think we need to be worried about moving money from one account to another – one bookkeeping trick to another – to just balance books and hopefully get more federal dollars. I mean, it does seem to be a bit confusing.”

The bill moves the Senate for consideration.

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Kentucky To Expand Medicaid Managed Care But Will Increase Oversight

Kentucky is moving forward with plans to establish Medicaid managed care programs around the commonwealth. The state saved millions of dollars in Louisville through a managed care program called Passport, even though questionable spending ultimately led to a management shakeup. Health and Family Services Secretary Janie Miller says any new programs will face strong oversight.

“They have to understand, and you have to have developed by that time, what is it you’re looking for? How are you going to hold accountable? What is it you’re seeking them to do? And you build that within the contract process,” she says.

Miller says several entities are already expressing interest in establishing Medicaid managed care programs around the state, but it’s too early in the process to reveal any additional information. On Tuesday, the Kentucky House approved a Medicaid budget balancing plan proposed by Gov. Beshear.

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Beshear’s Medicaid Budget Plan Passes House Committee

Governor Steve Beshear’s plan for balancing Kentucky’s Medicaid budget has passed the House Appropriations and Revenue Committee.

The plan involves moving $166 million from the second year of the Medicaid budget to the current year. Any second-year shortfall will be covered by savings from managed care, says State Budget Director Mary Lassiter.

“It’s not a matter of whether we’re going to balance this budget, it’s a matter of how and when,” she says. “And our plan to save that additional $39 million in state funds is all directly related to our managed care approach and these requests for information.”

Representative Jimmie Lee says if lawmakers fail to enact the governor’s plan, the impact will be disastrous.

“We’ve got to pass this movement of these dollars in order to provide the quality of care that we need for those 800,000. And then we need to have the dedication and the fortitude to move on and look at these areas in ’12 that will provide the managed care approach,” he says.

The committee also said yes to legislation raising the state’s drop out age from 16 to 18 by 2016. The bill, which already has House Education Committee approval, moves to the House floor, as does the Medicaid bill.