Sunday, March 13, 2011

Governor's Medicaid power play hits providers and most needy recipients

On Friday, the Health and Family Services Cabinet Cabinet issued public notice for Medicaid rate reductions to take effect April 1 if no budget agreement is reached.

The cabinet will significantly reduce payment to hospitals, nursing facilities, home health agencies, community-based services, pharmacies, comprehensive care centers, primary care centers, local health departments and other providers of Medicaid services in the commonwealth. The rate reductions are approximately 35 percent.

Gov. Beshear has called a special session beginning Monday to address the Medicaid budget hole. He says he can’t reduce a single dollar -- not $1 -- of spending anyplace in the state budget except for his promises for cuts in Medicaid.

Kentucky employees provided Beshear many ideas for reducing spending that he apparently can’t see:

- Eliminate potential duplication at the Education Cabinet's Office of Training & Employment (OET) and the Economic Development Cabinet's Bluegrass State Skills Corp. (BSSC) and its Workforce Training department.

- Quit sending teachers and administrators to conferences when they are nearing retirement or can’t apply conference materials when returning to work.

- Don't mandate purchases off bid lists when local options are quicker and less expensive.

- Shift money currently spent on educational grants, special programs and "experts" from Frankfort, to where it matters most -- classrooms.

- Answer: "What happened to all the lottery money that was supposed to be spent on education?"

- Address wasted energy in school facilities.

- Cut back on administrative staff all over.

Maybe it's time to remind the governor about his commitment to do an efficiency study that would save the state $160 million to $180 million per year. Maybe it's time to ask him to provide an accounting of savings realized from taking action on the thousands of suggestions received from state employees to save money.

Maybe Beshear should bring to the table Monday details about how he is going to save all those dollars in future Medicaid payments as a result of his requests for information from Medicaid providers.

Not $1! Not $1. But he can decree a 35 percent cut to entities that have to make a profit to survive -- a 35 percent, cold-turkey cut on Kentucky businesses. It must be nice to decree it and not get one challenge from the "yes" crowd.

Of course, it's much easier to point the finger and force pain on others than make tough internal decisions cutting unnecessary spending that could avoid it all.

It's time for some adult leadership on state spending in all areas.


Anonymous said...

The Governor and legislators have plenty of time communicate with understanding. The fact they don't means they just don't want to put partisan politics aside. Medicaid is a high stakes game in Kentucky. The Governor taking spending cuts off the table in negotiations is ridiculous.

I looked through the database of employee suggestions. If the Governor thinks his shop is perfect he better take another look. Leaders in the private sector would be embarrassed by many of the suggestions. It appears the Governor's managers just don't care. Maybe they don't because it's not their money they are spending or wasting.

Saving one cent is better than not even trying.

Anonymous said...

The teachers union tells the Governor and legislators they need more and more money for education. There will never be enough money to satisfy the teachers union and they admitted that on KET.

However, the Governor better look through the suggestions he got from employees. There are many $s to be saved in education that don't touch KEA teachers, salaries or benefits.

It's time for the Governor and legislators to get real about just throwing money at education because the teachers union says so. Surely these folks have a brain they can use to see price/performance can be improved with less dollars, not more.

Anonymous said...

It looks like the Governor and the senate republicans are playing a game of chicken. The only thing is they don't get hurt - only medicaid providers and needy people get hurt by the political games.

It would be nice to see the Governor take $166 million out of existing planned spending. Just look at what employees suggested.

Anonymous said...

Power politics will keep Kentucky at the bottom. Governor Beshear should step up to the bar, forget all the lobbyists and challenge every dollar state government spends.

He has been running on automatic pilot while Kentucky is in a financial viability tailspin. He says the unfunded state pension liabilities will correct themselves in 15 - 18 years! Other states are acting now.

Maybe he doesn't get the papers and know what the governors of Ohio, Indiana, Tennessee, Wisconsin, Texas and New Jersey are doing.

Tough acts to follow. Maybe too tough.

Anonymous said...

Kentucky politicians have always been great at preserving 'the way we do things around here'. That means partisan. That means ducking the tough issues. That means caving to lobbyists. That means putting their personal interests before all else.

Beshear is governor because he played the game better than anyone else. Why would he want to cut any spending that might cost him 1 vote? The protected state work force is a big voting block.

Now we all pay for that mentality. We lose. The elected fat cats always win.

Kentucky needs a courageous leader, not a politician.

Anonymous said...

How does the governor really think that borrowing $166 million will help solve anything!?! More federal funds=more deficit.