Issue Background

Medicaid

Medicaid Payments

The Department of Human Services has prepared a letter providing details of the payment increases that took effect on. January 1, 2016. See the letter.

DMAHS Newsletter Volume 25 Number 15 Increased Funding Preventive Care December 2015

 

MSNJ statement regarding Medicaid expansion:
“Governor Christie’s decision to expand Medicaid is a positive step that will create access to health insurance for many uninsured residents. Importantly, this decision will make additional investment in the program possible. This is also an opportunity to align incentives and create a robust network of physicians and other healthcare providers for the Medicaid program. Expanding an underfunded program will increase access to insurance, but will not deliver adequate access to physician services for our newly insured citizens.”

MSNJ supports reform of the State’s Medicaid program to meet the expanded demand.
Specifically, we would support the following actions:
1. Make the use of single case agreements easier, where applicable, so patients can get timely access to specialty care.
2. Reduce hassle factors for physicians participating in Medicaid. For example, remove prior authorizations for routine services.
3. Streamline credentialing by fast tracking into Medicaid MCOs physicians who are already credentialed in a carrier’s commercial plan.
4. Incent outpatient care over inpatient care, with dollars following that shift, since in the majority of cases outpatient care is more cost effective.
5. Focus on the implementation of the ACO and PCMH legislation and other pilots like surgical homes, since we have already seen cost savings and outcome improvements from Medicare and private models. (For example, New Jersey successes are cited here: (http://www.njspotlight.com/stories/14/01/30/feds-cite-healthcare-savings-from-models-widely-adopted-in-nj)
6. Phase in sustained increases in primary and specialist fees to adequately compensate them.