More need Medicaid; less money is available

By Cy Ryan (contact)

Saturday, June 28, 2008 | 2 a.m.

Carson City — The 187,000 people enrolled in the state medical assistance program may have to wait longer to see a doctor or specialist.

The state is losing $20 million in federal funds in its Medicaid program while the number of recipients is increasing.

So the state Division of Health Care Financing and Policy has decided to cancel a new program to treat traumatic brain injury that would have cost $1 million next year.

And it’s going to cancel a rate increase for doctors and specialists who treat Medicaid patients. There was $17.2 million set aside for the higher payments next year.

Division Administrator Chuck Duarte said patients may have to wait longer to see a specialist. Some physicians may not accept Medicaid patients.

Sen. Bob Coffin, D-Las Vegas, called it a “life and death situation” and criticized Gov. Jim Gibbons and the Legislature’s unwillingness to increase taxes to address the growing shortfalls in the state budget.

“There is risk associated with delayed care,” Duarte said. In dire cases, patients could go to emergency rooms, which can be less effective and is more expensive.

Sen. Barbara Cegavske, R-Las Vegas, said everybody has to wait for treatment from specialists, not just those on Medicaid.

Medicaid recipients are being added faster than anticipated by the 2007 Legislature. The Legislature put enough money in the budget for 163,819 patients on Medicaid, and the number is up to 187,000. In the fiscal year that starts Tuesday, the budget allows for 167,204 patients.

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When the state took title to 50 acres in Clark County to build a readiness center for the Nevada National Guard, it capped the career of state Lands Registrar Pamela Wilcox.

Wilcox, 66, is retiring this month as the longest-serving top state administrator. She has been buying and selling thousands of acres of state lands for 25 years.

She has overseen almost $300 million to purchase land for park expansions, wildlife areas, office buildings and prisons. She coordinates purchases for every agency in state government except transportation, the university system and the Legislature.

Wilcox was instrumental in acquiring land in Clark County for the Sawyer State Office Building, the state Department of Motor Vehicles, the National Guard and the prison at Indian Springs. The state presently owns about 250,000 acres, mostly in isolated areas. Much of its resources were concentrated on preserving Lake Tahoe.

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Southern California Edison has served notice on the Nevada Tax Commission that it is going forward with its appeal to recover more than $40 million in taxes.

Tony Smith, a representative of the company, told the commission Wednesday it intends to continue to appeal the case. “We won on the merits before. We will win on the merits again.”

The Nevada Tax Commission in May 2005 granted the refund, which has been gathering interest at 6 percent a year since 2003. The Nevada Supreme Court in April overturned the decision of the tax commission, ruling that it had violated the state’s open meeting law by making its decision in private.

Southern California Edison operated the Mohave power plant near Laughlin by importing out-of-state coal. Nevada taxed out-of-state coal while exempting coal and other minerals mined in the Silver State. Southern California Edison argued it was entitled to the exemption.

After the tax commission made its decision in a closed-door session, former Attorney General George Chanos filed suit to void the tax refund on grounds it was made in an illegal private meeting. District Judge Michael Griffin of Carson City upheld the decision of the tax commission but the Supreme Court voided the ruling.