JACKSON - Thousands of Medicaid participants have until Oct. 1 to prepare for the switch to Medicare because federal rules won't allow the state to make major changes in the program in the middle of a month, Mississippi's Medicaid director says.
The state's deadline is Sept. 15 for participants to be notified of the changes. However, Dr. Warren Jones said that under federal guidelines participants can't lose their benefits in the middle of a month. So the changes go into effect Oct. 1.
His comments came during a hearing Wednesday before a Senate committee. Only a handful of Medicaid recipients attended the hearing. The room was packed with lobbyists, legislators and health care advocates.
About 65,000 people would be affected by the proposed changes. About 47,000 of those will automatically qualify for Medicare, a federal health care program for the underprivileged.
Jones said the changes will save $30.7 million within the Division of Medicaid, which operates with federal and state funds.
The state is applying for federal waivers to keep providing coverage for about 18,000 Medicaid participants with certain chronic illnesses. This would include coverage for people who need anti-rejection drugs after organ transplants or who need chemotherapy, kidney dialysis or anti-psychotic drugs.
Jones told lawmakers that there is a provision in the waiver that would increase the number of people covered, if needed. The federal government hasn't approved the waiver.
"I am fully confident and have no doubt in my mind that this waiver will be approved and well before Sept. 15," Jones said.
When asked about restoring the benefits, Jones said unless additional funding is provided, Medicaid would be forced to eliminate some other categories of service and eligibility.
Much of Wednesday's discussion was about prescription drug coverage for people who don't qualify for Medicare. The state is trying to enroll those recipients in patient assistance programs offered by pharmaceutical companies.
Sen. Billy Thames, D-Mize, said one of his constituents has been unable to find a patient assistance program for all of her medications.
"What we're asking people to do is simply unreasonable," Thames told Jones. "We are requiring you and your staff to do the impossible."
Sen. Willie Simmons, D-Cleveland, said he wanted Medicaid to compile a list of recipients who might "fall between the cracks."
Jones said he has instructed his staff to keep track of the people they were able to assist and those they couldn't help. They also must log the number of recipients whose out-of-pocket expenses would exceed $50 a month.
"It's going to take a while to get that data," he said.
Sen. Hob Bryan, D-Amory, said the problem with the pharmaceutical plans is that patients would have to know in advance what prescriptions they'll need. He also accused the Medicaid staff of telling lawmakers that everyone would have coverage under the legislation they approved this spring.
Jones replied that he was "disheartened by your mischaracterization" of the Medicaid staff. Jones said his staff has "has reached and helped" 18,000 so far.
Wheeled onto the floor of the hearing was 26-year-old Ruth Riley, who was left a quadriplegic after an accident 11 years ago. Riley's mother, Ruthann Myers of Potts Camp, pleaded with lawmakers and health care advocates to move forward with the changes.
Myers' daughter won't be affected by the Medicaid changes. Her concern is that the growth of Medicaid spending could eventually force officials to cut the benefits the disabled woman receives.
"Let our government deal with it and take care of it instead of fighting it," Myers said.
Senate Public Health and Welfare Chairman Alan Nunnelee, R-Tupelo, said another hearing will be held a few weeks after the changes go into effect to gauge "where we are, what progress has been made, what questions still have not been answered."
About 720,000 people are enrolled in the state Medicaid program. Those affected by the cost-cutting move are some of the program's older and disabled patients.
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