Medicaid

In Crisis: Idaho Medicaid In Flux Causes A Big Shift In Care

Oct 31, 2014
mental health, in crisis
Katherine Jones / Idaho Statesman

Nine-year-old Kendra sits in one of the private rooms on the second floor of Boise’s Downtown public library with her community-based rehabilitation services worker, Jennifer Beason.

Beason slides a workbook to Kendra. It is what she calls her feelings journal. “Do you know what relieved is?” she asked.

Without missing a beat, Kendra rattles off examples of feeling relieved.

DBKing / Flickr

The Supreme Court will decide whether private sector health care providers can force a state to raise its Medicaid reimbursement rates to keep up with rising costs.

The justices on Thursday agreed to hear an appeal from Idaho.

The state is trying to overturn a lower court decision that ordered the state to increase payments.

Becky diVittorio, Optum
Idaho Statesman

A federal agency is investigating whether the company Idaho hired to manage part of its Medicaid program has violated patient-privacy laws.

Optum Idaho, a unit of United Behavioral Health, took over insurance management for Idaho Medicaid's mental-health and substance-abuse patients last fall.

Local health-care providers who treat those patients say Optum has erroneously sent them reports meant for other providers. The reports show patient names and mental-health or substance-abuse services the patients received or were authorized by Optum to receive.

Federal Officials Order Medicaid To Cover Autism Services

Aug 26, 2014

When Yuri Maldonado's 6-year-old son was diagnosed with autism four years ago, she learned that getting him the therapy he needed from California's Medicaid plan for low-income children was going to be tough.

Darin Oswald / Idaho Statesman

The state’s effort to rein in Medicaid costs has created deep friction between small businesses that deliver behavioral-health services to Medicaid patients and a new contractor hired to manage them.

Service providers across Idaho have raised complaints over the last 11 months that the contractor, Optum Idaho, a unit of United Behavioral Health, has created red tape and cut services needed by at-risk patients.

Stethescope, Health Care, Doctor, Medical
Emilie Ritter Saunders / Boise State Public Radio

An Idaho work group says the state should expand its Medicaid eligibility, but committee members voiced concerns that their recommendation will be ignored by both the governor and legislators.

The 15-member group voted Thursday to submit their recommendation to Gov. C.L. "Butch" Otter.

This is the second time this work group has supported expanding Medicaid to provide coverage to the state's working poor. Their 2012 recommendation, however, has been ignored for the past two years.

Lawrence Wasden
Idaho Public Television

Idaho attorneys are requesting that the U.S. Supreme Court consider a state appeal of a lawsuit challenging Medicaid provider reimbursement rates.

Attorney General Lawrence Wasden filed the petition paperwork Wednesday on behalf of the Idaho Department of Health and Welfare.

The state's appeal requests the justices to decide on a 2009 case where five providers alleged that Idaho's Medicaid rates were too low because they were kept at 2006 reimbursement levels.

An Idaho workgroup reconvened Wednesday to reevaluate options on how to offer medical services to low-income adults who don't have health insurance.

Gov. C.L. "Butch" Otter has repeatedly said he does not want to expand the state's current Medicaid program but has appointed a 15-member group to consider other possibilities.

The panel first met in 2012 and recommended expanding the state's Medicaid eligibility requirements.

Some students headed to college this fall will get top-drawer health coverage at little or no cost.

How? Medicaid, it turns out, will pay the premium for the student health plan.

Proponents say students who are eligible for Medicaid, the health insurance program for low-income people, get access to a wider network of doctors and hospitals by getting coverage through the college health plans. These broad networks can be an important consideration for students who travel for internships, international study or who return to homes far from school during the summer.

Transcript

STEVE INSKEEP, HOST:

Many republican governors have taken a stand against Obamacare by refusing to expand Medicaid. Utah, which is one of the most republican states in the nation, remains undecided. But in a state where the majority of the population are Mormons, one bishop from the Church of Jesus Christ of Latter Day Saints says helping the poor is a moral obligation. Andrea Smardon from member station KUER in Salt Lake City has more.

(SOUNDBITE OF CHECKOUT SCANNER)

Butch Otter
Emilie Ritter Saunders / Boise State Public Radio

Idaho Gov. C.L. “Butch” Otter says no matter what, the Affordable Care Act, or Obamacare as it's known, was coming to Idaho.  

“Because if we hadn’t [have] established our own state exchange, we would have had Obamacare in Idaho,” he says. “We didn’t have a choice. We were going to have an exchange in Idaho. We were going to have the Obamacare exchange in Idaho or we were gonna have [an]  Idaho exchange in Idaho.”

Emilie Ritter Saunders / Boise State Public Radio

Russ Fulcher says incumbent Gov. C.L. “Butch” Otter no longer represents the heart of Idaho's Republican Party.  

Fulcher, a state senator from Meridian, has been on the campaign trail since late November spreading that message. He’s the tea party candidate trying to unseat a longtime cowboy politician he says has a political “machine” behind him.

medical, stethoscope
Jasleen_Kaur / Flickr Creative Commons

A U.S. District Court judge issued an injunction Tuesday to halt deep cuts to Medicaid and restore about $16 million in assistance to Idaho's developmentally delayed adults.

The decision lets an American Civil Liberties Union (ACLU) of Idaho lawsuit on behalf of disabled Idahoans proceed as a class-action case.

That opens it up to more people who lost some their Medicaid dollars when the program was slashed in 2011.

Judge B. Lynn Winmill cited cases of severely mentally disabled Idahoans that can no longer afford necessary therapy and other care in his decision.

Utah's Republican governor has announced he wants to reject a full Medicaid expansion, and instead seek federal dollars to cover the poor.

Gov. Gary Herbert made the announcement Thursday afternoon, saying the state has an obligation to cover the poor by plugging a hole in the safety net.

The governor, who is one of the last in the country to announce a decision, is generally opposed to the federal health law but says his decision will help people pay for health coverage in the private market.

Lawmakers voted 62-6 to restore adult Medicaid dental benefits, arguing cuts three years ago that left 27,000 people without coverage cost Idaho more in dental-related emergency room services than it saved.

The House vote over the $1.4 million measure Tuesday pitted arguments for good preventative dentistry against fiscal hawks who say federal deficits trump good oral hygiene for low-income, elderly and disabled people.

Minority Leader John Rusche of Lewiston argued it not only made sense from a health perspective, but also from a fiscal perspective.

Pages