Summary of Medicaid budget cuts provided by HFS at Friday, February 20 Medicaid Advisory Committee meeting

Effective cuts for HFS totals $1.4B

Cuts include:

  • Rates and services (added back after SMART Act, primarily through SB741 in 98th GA, signed June 2014)
  • Roll back nursing home rate increase in $215.8M
  • Elimination of adult dental – $32M
  • Roll back SLF increase - $13.8M
  • Roll back increased reimbursement to ambulance providers – $13.8M
  • Cut renal dialysis – $13.8M
  • Eliminate safety net hospital add ons – $9.2M
  • Roll back increased home health rate – $5.5M
  • Elimination of adult podiatry services – $4.6M
  • Eliminate exceptions to four-script limit – kids in complex care CCEs – removed $4.6M
  • Roll back rates proposed for SMRFS (new provider type created for some of current IMDs) – $3.7M
  • Roll back new rate increase for child psychiatric hospitals – $3.7M
  • Roll back rate increase for transitional care facilities $.5M
  • Cuts to optional services and rates
  • Eliminate funding for IMDs – $74.7M
  • Eliminate care coordination fees to ACEs and CCEs – $60M
  • Reduction in managed care rates – $54.9M; ~1.5% depending on population being served
  • Program changes will result in lower rates as well
  • Working with actuaries to ensure that they are on the lowest rates
  • Decrease pharmacy dispensing fee for brand and generic by $2.40 – $46.2M
  • This would result in a $0 dispensing fee for brand and $3.10 for generics
  • Tightening DME and supplies contracts and usage – $29.8M
  • Eliminate renal dialysis for non-citizens – $9.3M
  • Eliminate kidney transplants for non-citizens – $7M
  • Raise DON score as we move towards UAT for LTS eligibility – $7.1M
  • Reinstate therapy limits from SMART Act – $1.6M
  • Program integrity – ensuring timely redes $53M
  • Increased resources to Inspector General to combat provider and recipient fraud $21.5M
  • Eligibility reductions
  • Eliminate Medicaid under IL Breast and Cervical Cancer Program – most people can move to Marketplace $32.3M
  • Eliminate state hemophilia program – $4.6M – go to the Marketplace first – actually spend very little in state program now, $4.6 does not represent reduction of services, just appropriations
  • Eliminate state renal program – $100,000
  • Eliminate All Kids eligibility for kids who already have private insurance (for kids in Share and Premium levels, 150-300% FPL) All Kids
  • Eliminate Health Benefits for Workers with Disabilities – $1.4M
  • Proposed changes to hospital static payments – elimination of current GRF payments – these payments are not tied to any specific services - $334.9M
  • Take $400M of payments to hospitals that are static payments funded by hospital assessment and use to pay claims based hospital payments – paying for services instead of lump sum payments to hospitals – instead, redirect these dollars to pay for general Medicaid services instead of only to hospitals; ACA $400 payments to hospitals, should help offset this proposed change
  • $12.5M operational savings to HFS