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April 24, 2014

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Medicaid cutbacks could result in rationing of medical care, officials say

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Sam Morris / File photo

University Medical Center is Clark County's only publicly funded hospital.

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CARSON CITY – Cutbacks in Nevada’s Medicaid program could lead to a rationing of medical services and financial difficulties for hospitals, witnesses told a legislative budget subcommittee on Wednesday.

Kathy Silver, chief executive of University Medical Center, said a 5 percent proposed reduction in payments for Medicaid payments would result in a $6.3 million cut to the public hospital in Las Vegas.

Silver said other hospitals in Southern Nevada might transfer their Medicaid patients to UMC because the doctors in those hospitals could refuse treatment due to lower reimbursement rates.

The Legislature reduced the Medicaid rates for hospitals in 2008 and UMC lost $30 million as a result.

Chuck Duarte, administrator of the state’s Medicaid program, which provides care for the indigent, outlined the cuts recommended by Gov. Brian Sandoval to the program with 280,000 patients. It is projected to grow to 312,000 patients by the end of 2013.

Bill Welch, representing the Nevada Hospital Association, said 10 of the 13 hospitals in Clark County are operating at a loss. “We can’t continue this,” he said, and predicted a “significant change in services.”

Larry Matheis, representing the Nevada State Medical Association, said he has “grave concern” over the proposed reduction in rates for doctors treating Medicaid patients.

He said physicians providing specialty care are not being paid for their costs in treating patients. He predicted this would lead to rationing of medical services due to insufficient payments.

The governor’s Medicaid budget calls for transferring costs to counties. Bobby Gordon and Susan Rhodes of Clark County said the county would have to absorb $17 million more to care for nursing home programs, with possibly $6.5 million on top of that for expanded services.

Gordon said this would result in a “serious impact” to the county.

Duarte said the proposed budget calls for a rate reduction of $20 per day per patient at nursing homes. The payment to nursing homes now is $189 per day per patient. He said Nevada was in the middle of western states on its the rates paid for Medicaid payments.

Duarte said 60 percent of patients in nursing homes are on Medicaid and private rates paid are higher than rates paid by the state.

There would also be a cutback in clinical services for mentally challenged children on Medicaid. Duarte said a child has to show improvements or Medicaid would no longer make payments.

There is a proposed 15 percent reduction to those who provide home and community-based services to the elderly, for a savings of $1.3 million. That includes adult day care.

The state would also eliminate paying for glasses for adults in the Medicaid program, but eye examinations would still be covered. That is expected to affect 7,833 adults, Duarte said. The state will still cover the cost of glasses for children.

He also outlined steps being taken to comply with the new federal health care law and said Medicaid “will have to create a new benefit package akin to private insurance.”

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  1. I'll bet the EMT Drivers don't get a cut in pay...

  2. Sand Oval's own Death Panels....

  3. In California, Medicaid recipients are required to enroll in one of approximately 4 privately owned HMO's, and the state pays a fixed per-head premium. It seems like that would be a more rational approach to Nevada's Medicaid problems than letting patients run up doctor and lab bills willy-nilly, and letting hospitals pile on lengthy lists of itemized charges for Medicaid patients.

    Nationally, for both Medicare and Medicaid, the health care and pharmaceutical industries are going to have to accept government established price controls for everything, or the abolition of these programs, or mandatory institution of Medicare and Medicaid HMO's where the government sets the premium for how much it is going to pay for each person each year.

    That's the fact, whether the medical industry, the free-market thinkers, the doctors, the hospital employee unions like it or not.

    Senior citizens and those in their 50's have been guaranteed they will receive Medicare when they retire. They have been paying into Medicare for their entire working lives. From an "angry voter" standpoint, this massive voter demographic is not going to stand for being ripped off by the Federal government the medical industry, the free-market thinkers, the doctors, the hospital employee unions.

    Think the rioting in the streets of Egypt and Libya has looked vehement? Just watch what happens when the Federal government tries to end all Medicare coverage, instead of instituting Medicare HMOs.

  4. Senior citizens and those in their 50's have been guaranteed they will receive Medicare when they retire. They have been paying into Medicare for their entire working lives. From an "angry voter" standpoint, this massive voter demographic is not going to stand for being ripped off by the Federal government the medical industry, the free-market thinkers, the doctors, the hospital employee unions.

    *****

    Medicare is not free. Everyone enrolled and that is on Social Security, has money taken out of their SS checks every month. It's not a lot, average about $100 a month, but when a senior only gets $400 in SS payments every month, that money is a LOT. That is why all have to have secondary.

    The Republicans want to F*** with one of THE largest segments of our population - the Baby Boomers. They seem to forget people over 55 vote!!! The riots in Egypt, Libya and even Wisonsin will seem mild in comparison when this group goes to the streets - again!

  5. The Repugs would not have to cut Medicaid if the fraud would stop. It is RAMPANT, especially in nursing homes.

    And I agree with roseanrose - stop providing it to the illegals. AND....get a better system to stop the fraud - FINGERPRINT ALL those applying. You have to be fingerprinted for any federal or state job so why not get fingerprinted when applying for federal or state benefits???? ANYONE can come up with a social security number - but you can't change finger prints.