NC legislators troubled again by Medicaid finances - WNCN: News, Weather

NC legislators troubled again by Medicaid finances

Posted: Updated:
RALEIGH, N.C. -

The General Assembly set aside more than $500 million this year to handle the ever-increasing costs of Medicaid, which legislators and Gov. Pat McCrory said prevented them from giving raises to state employees and teachers a few months ago.

Now legislators already are getting worried even a 13 percent increase in overall state Medicaid spending compared to previously expected needs won't be enough to cover the treatment of 1.7 million mostly poor children, older adults and the disabled. It threatens to again jeopardize employee raises and other spending that has been curtailed since the Great Recession.

"We have other demands on the state budget," Sen. Tommy Tucker, R-Union, said this week. "It's getting harder and harder to explain to our constituents why we can't fund some things."

Tucker made the comments as state budget officials and Health and Human Services Secretary Dr. Aldona Wos told a legislative oversight panel it was too early to tell whether Medicaid data portended a shortfall this year. But lawmakers were troubled by information they provided.

The state spent 26 percent of the funds the budget law allocated to Medicaid through the first quarter of the fiscal year, the three months ending Sept. 30, the state budget office said. Although the first-quarter percentage spent a year ago was 31 percent, this year's figures didn't include provider claims delayed due to problems with the state's new Medicaid billing system, the office said. The state would pay one-third of the amount of the estimated $350 million to $400 million in pending claims.

Medicaid spending also is historically weighted toward the second half of the fiscal year, Assistant State Budget Officer Pam Kilpatrick said.

"We're looking at different ways to try to get a handle on this, but in the first quarter I don't think we're prepared to say what we think the end of the second quarter or third will look like," Kilpatrick told Tucker.

Rep. Donny Lambeth, R-Forsyth and the retired president of North Carolina Baptist Hospital, said at Tuesday's meeting that it didn't take a sophisticated model to determine all of DHHS, which includes Medicaid, could easily face a shortfall of $350 million to $500 million. "That's something we all should be concerned about," he said.

There are new challenges that make projections difficult, including how much Medicaid services will increase as more of the new federal health care overhaul law takes effect. An improving economy could also scale back Medicaid enrollment and ease funding demands.

The state Medicaid office is now asking federal regulators to sign off on dozens of Medicaid plan charges, many of which will result in cost savings. About $3.5 billion of the $13 billion the Division of Medical Assistance is projected to receive this year to operate Medicaid come from the state.

The new billing system called NCTracks is also supposed to provide detailed analytic information to better project Medicaid trends. A division official said Tuesday it would be December before information is available — news that bothered Sen. Pete Brunstetter, one of the chamber's chief budget-writers.

"I am very uncomfortable with where we are on the Medicaid budget," said Brunstetter, R-Forsyth. "It only takes a few percentage points of deviation on the Medicaid budget to put the entire state budget" in a grave situation, he added.

The legislature had to locate up to $496 million before the most recent fiscal year closed June 30 to cover a Medicaid shortfall. It was attributed in part to a miscalculation of expected federal funds that Wos' office pointed out in May occurred when Democratic Gov. Beverly Perdue's administration was in charge.

Legislative Democrats said Republicans are as much to blame for recent shortfalls.

Perdue and her DHHS Secretary Lanier Cansler told GOP budget writers in 2011 that unrealistic cost-saving demands combined with massive enrollment increases during the recession were setting Medicaid up for a shortfall. In October 2011, the agency warned a legislative oversight committee of a $140 million shortfall that later grew.

"It was (the Republicans') budget that was out of whack. It wasn't our budget," said Senate Minority Leader Martin Nesbitt, D-Buncombe. Still, Nesbitt acknowledged budget forecasting is extremely difficult for Medicaid because it's an entitlement program that must serve all citizens who qualify for services.

A performance review by State Auditor Beth Wood's office in January, however, criticized the Division of Medical Assistance for failing to appropriately manage Medicaid costs within their control and keep an accurate picture of current finances.

McCrory and Wos are assembling a Medicaid reform plan they say will provide financial stability. Wos wouldn't say Tuesday whether she would recommend shifting Medicaid to a manage-care model, where private companies would be paid a specific amount monthly for each patient.

Potential relief could be a long way off. The proposal, expected by mid-March, still would have to be approved by the legislature and federal regulators. A reform framework laid out by McCrory and Wos last spring said incremental implementation wouldn't start until July 2015.

  • Trending StoriesTrending StoriesMore>>

  • 77-year-old questioned, defended as true Marine after NFL player takes his photo

    77-year-old questioned, defended as true Marine after NFL player takes his photo

    Tuesday, July 22 2014 1:58 PM EDT2014-07-22 17:58:35 GMT
    (WMC) - It was a story that made its rounds on social media. On a recent flight DeAngelo Williams, Mid-Southerner and running back for the Carolina Panthers, gave his first-class plane seat to a 77-year-old
    Family members are upset and hurt that their relative, James Wesley Bolden, is being called a liar and "a fake."
  • Largest companies by revenue in each state

    Largest companies by revenue in each state

    Thursday, July 10 2014 8:01 PM EDT2014-07-11 00:01:10 GMT
    Broadview Networks recently decided to find out the biggest -- by revenue -- company in each state in the US.The company used the Fortune 500 list to start with, but needed data by state, so it turned to Hoover's.With data from that company, they were able to search through each state's list of companies and then find the largest -- by revenue.Just flip through the list above and see who is the biggest in each state, what town they are based and their revenue.
    Broadview Networks recently decided to find out the biggest -- by revenue -- company in each state in the US.The company used the Fortune 500 list to start with, but needed data by state, so it turned to Hoover's.With data from that company, they were able to search through each state's list of companies and then find the largest -- by revenue.Just flip through the list above and see who is the biggest in each state, what town they are based and their revenue.
  • Air Algerie jet with 116 on board crashes in Mali

    Air Algerie jet with 116 on board crashes in Mali

    Friday, July 25 2014 2:56 AM EDT2014-07-25 06:56:56 GMT
    The official Algerian news agency says an Air Algerie flight from Burkina Faso to Algiers has disappeared from the radar.
    An Air Algerie jetliner carrying 116 people crashed Thursday in a rainstorm over restive Mali, the third major international aviation disaster in a week.
Powered by WorldNow

1205 Front St., Raleigh
N.C., 27609

Telephone: 919.836.1717
Fax: 919.836.1687
Email: newstips@wncn.com

Can't find something?
Powered by WorldNow
All content © Copyright 2000 - 2014 Media General Communications Holdings, LLC. A Media General Company.