Health providers gird for DHHS cuts under compromise deal

Lawmakers may have reached a bipartisan deal to close a budget gap at the Department of Health and Human Services, but health care providers are still bracing for deep cuts.

Members of the Legislature’s budget committee pushed back against Gov. Paul LePage’s proposal to drop coverage and tighten eligibility for some MaineCare beneficiaries, but left intact cuts to reimbursement rates for hospitals. Under the deal passed unanimously early Wednesday morning, hospitals will lose $10.1 million over the next two years on services they provide to MaineCare patients.

Hospitals also face a second hit from cuts outlined by a streamlining task force, which called for another $3.1 million drop in reimbursements.

The federal government kicks in roughly $2 for every $1 the state spends on MaineCare, the state’s version of Medicaid. So the proposed cuts for hospitals mean a loss of nearly $40 million in state and federal monies combined.

“It’s going to be a challenge to meet these cuts,” said Jeff Austin, a lobbyist for the Maine Hospital Association.

Eastern Maine Healthcare Systems will take an $11.8 million loss from the reimbursement cuts, with $8.4 million carried by Eastern Maine Medical Center in Bangor, according to Lisa Harvey-McPherson, who handles policy issues for the health system.

“I believe that hospitals continue to experience a disproportionate hit in the budget package that was passed last night,” she said.

EMHS is already owed $85 million for care provided to MaineCare patients that it hasn’t been compensated for, Harvey-McPherson said. Other hospitals are in a similar predicament, and piling on further cuts creates too heavy a burden, she said.

Two Democrats on the Legislature’s Appropriations Committee, Rep. Peggy Rotundo of Lewiston and Rep. Sara Stevens of Bangor, voted against the reimbursement cuts.

“For those hospitals that do take a lot of MaineCare patients, these cuts are devastating,” Rotundo said.

The committee did restore some planned rollbacks on outpatient hospital visits, she said.

Rotundo said she’s committed to finding more money to prevent the bulk of the reimbursement cuts from taking effect in 2013.

In a statement, House Speaker and pharmacist Robert Nutting, R-Oakland, said “the budget ensures that hospitals, pharmacies, nursing homes and other health care providers will continue to receive their reimbursement for Medicaid services provided.”

Lawmakers on the panel showed unanimous support for two controversial proposals, agreeing to cap MaineCare funding for childless adults, or noncategoricals, and reducing the income threshold for parents of children on MaineCare as of October.

Hospital officials have said LePage’s plan to drop noncategoricals from MaineCare would add tens of millions more in losses as hospitals pick up the tab for treating those patients, often in expensive emergency rooms.

The compromise deal offers some relief in that sense, Austin said.

“It’s less negative than the worst case scenario,” he said.

The deal preserves coverage for childless adults already on the rolls and extends a freeze on enrollment. About 14,000-16,000 people remain on a waiting list for noncategorical coverage through MaineCare, a DHHS official said in December.

Thousands of childless adults could lose needed benefits permanently by getting bumped from coverage as the result of a simple paperwork error, said Kevin Lewis, chief executive officer of the Maine Primary Care Association.

He also criticized the plan to tighten eligibility for parents of children on MaineCare, saying they’re among the cheapest people the program covers.

“It’s a mistake to try and balance the budget by eliminating coverage for people who have no other option,” he said. “We can’t wish away the ultimate health care costs that are going to show up regardless.”

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cuts

Why doesn't all the members of the legislation take cuts on their payroll and their insurance coverage and see if they can manage. I'm already fighting DHS because of a mistake they made and because of their mistake my income tax refund is in jeopardy. I've already lost my maine state refund. This is wrong. DHS takes money from people who are on the system because of the mistake DHS made. That's not right. Why should the people be punished for a mistake that wasn't their fault. Stop spending other people's money. I work as much as I can so That my 8 yr old can go to school and have food, a roof what I make versus my rent and bills barely lets me have any money left over for dr visits, car repairs or basic household necessities, toothpaste, toilet paper etc.... Why don't they take it back from the people who defrauded DHS. I have mainecare but I don't have dental. Maine care only pays $8.00 for eyeglasses and they break all the time because they are cheap. The only way I can get mainecare to pay for a dentist is if I break a tooth or need one pulled. I can't just go to the dentist to fill a cavitiy or to have my teeth cleaned. That isn't fair. The legislature is supposed to be helping those citizens that are having a hard time. Instead of going on those fancy vacations, buying that new car why don't some of you Take your bonuses and put it back into the system. If I could afford to live like that I would give up my bonuses. It's about caring, oh wait the only thing the legislature cares about is what in their pockets and who they can screw next.!!! I'm all for rules and regulations but it needs to apply to everyone. Starting with the lawmakers.

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