Another $60 million needed for Medicaid, panel told

Wednesday, April 27, 2005 | 11:09 a.m.

CARSON CITY -- A pullback in federal funding and higher than expected medical costs mean Nevada's Medicaid program will need up to $60 million more, a legislative budget committee was told this morning.

Chuck Duarte, administrator of the state Division of Health Care Financing and Policy, said his agency will need anywhere from $17 million to $36 million for the Medicaid and children's health program to get through the fiscal year that ends June 30.

Assemblywoman Sheila Leslie, D-Reno, chairwoman of the committee, told Duarte more explanations are needed about the shortfall and the needs, and they must be supplied quickly. She said the budgets are being finalized, and "we can only wait so long."

"Every day you wait puts the money in jeopardy," Leslie told Duarte.

Duarte's is the latest state agency to say it needs more money for the next two years based on new figures.

In his budget, Gov. Kenny Guinn recommended the state budget $393 per Medicaid recipient per month but now state officials realize that it will need to be $425 per person per month, Duarte said. Most of that increase is needed for care of the aged and blind.

Duarte said pharmacy costs and physician costs also have risen.

In Nevada Checkup, the program that provides low-cost health insurance for children, the estimated cost per recipient next year will be $110 per month but the previously budgeted amount of $106 per recipient per month.

Medicaid now covers more than 185,000 low-income aged, blind and welfare recipients. Guinn estimated that number will rise to more than 222,000 in the next two years.

The children's health insurance program now has more than 26,000 enrolled and Guinn's budget calls for that to rise to 30,000 in the next two years.

A change in the federal funding for Medicaid means $500,000 less in support over the next two years, he said.

A major revision Duarte is requesting in the state budget is needed to deal with the federal Medicare Modernization Act that will provide drug coverage for seniors, he said.

Duarte said the Guinn administration initially estimated it would save $17.8 million by enrolling those on Medicaid in the federal Medicare drug program. It would cost less to cover the premiums than to pay for the drugs for those in the Medicaid program.

Guinn's administration and Duarte's division wound up revising the projection of the savings down to $4 million. But now the state will have to chip in an additional $13.7 million over what the governor recommended.

Committee members wanted to know why there was not a solid figure for the extra money needed to get the Medicaid program through the end of the current fiscal year.

Duarte said the division may have to pay $17 million in "claims catchup" meaning that backlogged bills may still be unpaid.

He said the division may also have to pay $5 million to $6 million to University Medical Center in Las Vegas for treatment of Medicaid patients. He said there have been some problems in the billing procedure by the hospital.