Government Relations

UM Legislative Update Newsletter

November 11, 2005

Medicaid Reform Commission holds final two meetings

The Medicaid Reform Commission met for its final two meetings on Wednesday, Nov. 9 and Thursday, Nov. 10, 2005. The commission narrowed its discussions to nine major topics to be included in its final report, due Jan. 1. Topics include access to quality care; provider participation and satisfaction; wellness, prevention and responsibility; mental health; pharmacy; eligibility; managed care; technology; and long term care.

  1. Access to Quality Care: Recommendations centered on requiring a primary care physician, creating incentives for employees to provide insurance, supporting Federally Qualified Health Centers, decreasing the uninsured, promoting best practices, and decreasing underserved areas.
  2. Provider Participation and Satisfaction: Recommendations included increasing reimbursement, decreasing administrative burden, decreasing provider fraud, increasing patient compliance, and encouraging other providers in delivery of care. 
  3. Wellness, Prevention and Responsibility: Recommendations centered on promoting education, awareness and healthy lifestyles with incentives and disincentives.
  4. Mental Health: Recommendations focused on provider choice for patients, adequate delivery of care, and expanded local support.
  5. Pharmacy: The commission recommended methods for the better delivery of service, a range of copay options, and prior authorization of medications.
  6. Eligibility: Recommendations included re-examination and refinement of the determination process, revision of the Medical Assistance for Workers with Disabilities (MAWD) program, and creating a single point of entry for clients.
  7. Managed Care: The commission discussed both expansion and reduction of certain managed care programs and recommended a variety of methods for the delivery of care. 
  8. Technology: Recommendations centered on using technology to give providers of choice to patients, to better deliver care, and to help expand services and support in the local community.
  9. Long Term Care: Recommendations included clarifying methods for the definition of assets, encouraging long term care insurance, ensuring better delivery of care, and expanding local support.

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