Rules approved to move Medicaid patients to HMOs Implementation delayed until Feb. 1

November 09, 1996|By M. William Salganik | M. William Salganik,SUN STAFF

A legislative joint committee approved rules yesterday for moving 330,000 medical assistance patients into managed-care plans, but it delayed the start of the program for 30 days in response to requests from health providers.

The action by the Administrative, Executive and Legislative Review Committee means the program will begin Feb. 1, moving Medicaid patients into managed care within six months in an effort to save money and provide better-coordinated care.

About a third of the patients are already in health maintenance organizations.

Dr. Martin P. Wasserman, the state health secretary, had wanted to start the program Jan. 1, but he said of the delay, "We think this is an acceptable period of time to generate a level of confidence" in the program.

Pegeen Townsend, representing the Maryland Hospital Association, which had asked for a delay, said the 30 days "does buy us some time in terms of getting some provider networks in place. We're very pleased with the end result."

In addition to existing HMOs, the regulations give hospitals and other providers a chance to form their own managed-care organizations.

Like traditional HMOs, those organizations would be responsible for care for enrollees and would receive a flat fee per member per month from the state.

Provider groups have been scrambling to create the new entities or to work out contracts with others who do.

While approving the regulations, committee members expressed concerns that the switch be accomplished without hurting the medical care of recipients, who are mostly single mothers and their children.

"There are a number of us who still feel a little queasy," said Del. James W. Hubbard, a Prince George's Democrat. "It's important you get to us with problems before the people who are affected come to us."

Wasserman said the delay would eliminate $9.5 million in anticipated savings in this fiscal year, half from state funds and half from federal.

However, he said, there is a good chance the money can be found within the $2.5 billion Medicaid budget.

Pub Date: 11/09/96

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