Governor Rauner’s proposed 2016 budget cuts to medical assistance programs

For your information, the following is the list of Governor Rauner’s proposed $1.4+ billion 2016 Medical Assistance Program budget cuts as reported by Healthcare and Family Services (HFS) administrators to the Medicaid Advisory Committee on Friday. A copy of HFS’ budget presentation to legislators and advocates (but not shared at Friday’s MAC meeting) should be available online on Monday.

Many of the proposed budget cuts roll back provider rate increases and/or services provided in June of 2014 under Senate Bill 741 (Public Act 98-0651). Other proposed cuts roll-back even further to state fiscal year 2013 (SMART Act) levels.

  1. Eliminates nursing homes rate increases – $215.8 million
  2. Eliminates adult dental services – $32 million
  3. Eliminates rate increase to supportive living facilities – $13.8 million
  4. Eliminates rate increase to ambulance providers – $13.8 million
  5. Eliminates rate increase allocated to renal dialysis centers – $13.8 million
  6. Eliminates safety-net hospital add-on payments – $9.2 million
  7. Eliminates the home health care service rate increase – $5.5 million
  8. Eliminates adult podiatric services – $4.6 million
  9. Eliminates exemptions to the 4-prescription limit for psychotropic drugs and drugs for children with complex care managed by care coordination entities needs – $4.6M
  10. Eliminates proposed rates for Specialized Mental Health Rehabilitation Facilities – $3.7M
  11. Eliminates rate increase to children’s psychiatric hospitals – $3.7M
  12. Eliminates rate increase to transitional care facilities – $500,000
  13. Eliminates reimbursement to institutions for mental diseases (“IMDs”) – $74.7M
  14. Eliminates care coordination fees to ACEs and CCEs (Accountable Care Entities and Care Coordination Entities) – $60M
  15. Reduces managed care payments or rate by $54.9M (about 1.5%)
  16. Decreases the pharmacy prescription dispensing fees on all prescriptions by $2.40 [This translates to a $2.40 dispensing fee for generic drugs and a $0 dispensing fee for brand drugs] – $46.2M
  17. Adds durable medical equipment supplies – utilization controls – $29.8M
  18. Eliminates renal dialysis for non-citizens – $9.3M
  19. Eliminates renal transplants for non-citizens – $7M
  20. Raises the Long-Term Services score or Determination of Need (DON – to what level?) [This increases the threshold to obtain long-term care services] –  $7.1M
  21. Eliminates some physical therapy, occupational therapy, audiology services – $1.6M
  22. Speeds up “timely” redeterminations of eligibility [HFS/DHS still has a backlog of cases requiring eligibility redetermination] – $53M
  23. Provides for additional resources to the Medicaid inspector general to combat “waste, fraud, and abuse” [What is the cost of the additional resources?] -$21.5M
  24. Eliminates Medicaid eligibility under the Breast and Cervical Cancer Program [“most individuals could move to the health insurance exchange”] -$32.2M
  25. Reduces appropriations to the State Hemophilia Program – $4.6M
  26. Eliminates the State Renal Program – $100,000
  27. Eliminates All Kids “upper income” children who have other insurance – $2.9M
  28. Eliminates the Health Benefits for Workers with Disabilities program –  $1.4M
  29. Proposes changes to hospital static payments (General Revenue Fund payments) – [These funds “are not based on any services provided”] -$334.9M
  30. Takes $400M from the Hospital Assessment Tax and use these funds to pay for claims rather than lump sum or grant payments (Affordable Care Act (ACA) provides hospitals with a new $400M source of in lump sum payments) -$400M
  31. “Operational savings” – $12.5M

Total proposed (and life-threatening) cuts to medical assistance programs ~ $1,474,800,000

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