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Archive for Wednesday, March 28, 2007

Highlights of the house GOP plan

March 28, 2007

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Medicaid changes

Medicaid, administered jointly by states and the federal government, reimburses health care providers for services to the needy and disabled. In Kansas, its budget is about $1.3 billion, and it serves 250,000 people a month.

The Kansas Health Policy Authority would be required to file requests with federal officials to waive Medicaid rules so the state could move toward helping Kansans buy private insurance rather than paying for services. The authority administers Medicaid in Kansas.

The authority also would:

¢ Start a pilot program by July 1, 2008, in an area with "rural and urban characteristics," then take the program statewide by 2013.

¢ Determine the per-person cost of Medicaid for different groups of participants, then convert that cost to a credit or "instrument of value" to be used to purchase private insurance.

¢ Give Medicaid recipients "multiple options" for choosing health plans or setting up health savings accounts.

¢ Set up an "electronic" prescription program, based in the private sector by 2013.

¢ Convert payments for Kansans' nursing home care within five years to commercial insurance policies.

¢ Create a program of incentives for Kansans to plan for long-term care expenses.

¢ Set up a 24-hour telephone hot line providing medical information to Medicaid participants.

¢ Combat fraud and errors, reducing the error rate in payments to less than 5 percent by the fiscal year beginning July 1, 2008.

¢ Create a program under which people who pay their own hospital charges would receive discounts.

¢ Phase in a program providing assistance in paying insurance premiums to families below 100 percent of the federal poverty level, an annual income of $20,650 for a family of four.

Employer health plans

A new program within the Department of Commerce would be established to help small businesses develop "cafeteria" health plans for their workers.

Small businesses or organizations of "persons having a common interest" could form associations for purchasing health insurance. The Department of Commerce would be permitted to make no-interest loans or grants to associations to help them.

The insurance commissioner could waive any state rule or coverage mandate to maintain individual or group health insurance at affordable rates, or inside a geographic area where more than 13 percent of the residents are uninsured.

Other provisions

The state would set up an "insurance exchange" through which companies could offer different plans and Kansans could purchase health coverage. The exchange would have a board of directors and be run by a private administrator.

The exchange would have to allow Kansans who are eligible for an income tax credit for working families to dedicate that credit to paying for insurance.

A special trust fund, administered by a nonprofit foundation, would be set up to finance health care programs. For each of the next three years, $10 million in tobacco litigation settlement funds would be dedicated to the trust fund.

Health care facilities that provides charity medical care cannot be held legally liable in medical malpractice lawsuits for an action or failure to act unless they are "grossly negligent or willful and wanton."

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