Despite optimism early this week over a Senate budget conference
position proposal that made serious concessions to the House
budget position, we are at a new stalemate Friday.
The Senate budget position including reducing their proposed
trimming of the Medicaid rolls and leaving only $30 million between
House and Senate funding levels. Then Senators Hise and Pate rolled
out a new plan for the structure and operation of Medicaid and the
machine has screeched to a halt - and the screeching you hear is
doctors and hospitals objecting to the introduction of managed care
providers running our Medicaid system.
Under the proposal provider-led accountable care organizations or
managed care organizations would run the state's Medicaid
system and pay a flat per patient amount for all care for that
patient. A spokesperson representing physicians testified that the
additional administrative paperwork related to this approach,
should it be enacted, would certainly hurt access to medical care
for the poor. Currently nearly 90% of primary care physicians in
NC take Medicaid. Florida, which uses this managed care
approach have a much lower participation rate.
The House and the Governor have already voiced their opposition to
the plan. And we don't need to remind you that this brand new
proposal was unveiled two weeks after the Legislature should have
adjourned for the year.
Have a look at the Senate's plan here: http://www.ncleg.net/Sessions/2013/Bills/House/PDF/H1181v4.pdf
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