Fiscal Committee Highlights - August 13, 2003

Fiscal Committee Highlights

August 13, 2003

 

 

• Ge Brogden reported that, as result of the increased Medicaid federal participation last SFY, (which will continue into the current fiscal year) counties had saved a total of $6.986 million.   These savings were reflected in adjustments to county Medicaid cost calculations for July.

• NC Health Choice is currently budgeted to provide services to 100,000 children.   According to Ge, almost that number of children are currently enrolled.   No plans for a freeze on enrollment have been made at this point.

• Ge reported that 10 counties have exhausted all Medicaid De-linking funds allocated to them, and it appears counties will exhaust the remaining $2.5 million by June.

• Ge reported as of August, Medicaid expenditures are running at a projected rate of 8% above FY03’.

• Dave Mosley of DMA gave a detailed report of problems identified with payments to many NC hospitals from 1997 forward.   Overpayments have been made in relation to the system for settling costs for outpatient services.   Additional overpayments have been made in the Disproportionate Share Program because of erroneous data that has been used in calculating payments due many hospitals.   Finally, there is some possibility of questions relating to the eligibility of some hospitals to receive DSH payments at all.   All told, several hundred million dollars may be involved.   (Computations have not been completed, and will depend on some issue resolutions.)   The State is negotiating with the federal agency regarding the magnitude of the overpayments, and the amount that will be required to be repaid.   Counties will not incur additional costs directly from repayment of federal funds.   Counties may even have some refunds of the county share of overpayments to hospitals.   This is, however, a serious budget problem for the State, and for hospitals that will be expected to make repayments.   Counties may receive requests for financial assistance from local hospitals as result.

• Sherry Bradsher indicated the State would like to examine the CIP allocation process to assure it is optimal.   She asked for two representatives from the Fiscal Committee.

• Sherry also said an Atlanta HHS office review of our day sheet process in June and July had resulted in some expressed concerns about the accuracy of the system.   She indicated a report of the review will probably include a recommendation the State consider an RMS system.   She also predicted the existing system would be flagged for audit.