Feds approve Maine’s plans to reduce some Medicaid benefits

Changes will save Maine $4 million, reduce program size
Jan 08, 2013

Augusta — Maine Department of Health and Human Services Commissioner Mary Mayhew learned Jan. 8 that some of the legislatively approved reductions to the Medicaid program have received federal approval.

In a letter from the Centers for Medicaid and Medicare Services, Mayhew was notified that Maine’s State Plan Amendment to eliminate benefits for parents from 133 percent to 200 percent of the Federal Poverty Level was approved, as was a 10 percent reduction to eligibility categories in the Medicare Savings Programs. Maine’s additional request to reduce coverage for parents to 100 percent of FPL and elimination of eligibility for 19 and 20-year-olds remains was not approved by CMS, citing that the changes do not comply with certain requirements in the Social Security Act, as amended by the Affordable Care Act. These changes when implemented will save the state $4 million.

“We are disappointed that some of the changes approved by the Maine Legislature were not approved but pleased that we have gained some flexibility to manage the Medicaid program. We must continue to move toward a sustainable program that is much more in line with other states and Federal requirements,’’ Mayhew said in a news release. “The loss of federal stimulus funds has created an additional burden on state budgets. In Maine, while the overall Medicaid budget grew by less $16 million in state fiscal year 2012, the amount of state funding required grew from $526 million to $776 million or roughly 48 percent.”

The reduction to 133 percent of the FPL for parents will impact 12,592 recipients, though about half may be eligible for transitional Medicaid benefits for up to 12 months. With implementation of the reductions slated for March 1, the state will save more than $3.2 million.

All current cases will be reviewed to assure that no other Medicaid eligibility exists and members will receive letters notifying them of the change in benefits. All questions related to these reductions will be answered by the Member Services staff by calling 1-800-977-6740, TTY 711.

The changes in the Medicare Savings Plan will affect 8,250 people. Roughly 2,600 of these individuals will no longer be eligible for any benefits under MSP or drugs for the elderly. These reductions will save nearly $800,000. More than 80,000 Mainers will continue to receive coverage under MSP.

Maine’s generosity in the MSP program had been unmatched nationally, with just one state and the District of Columbia offering to pay premiums and other costs beyond the federal minimum.

“Clearly, these changes will be difficult for those who are impacted,” the Commissioner said. “I commend the Legislature for having the courage to make needed changes in the structure of Maine’s Medicaid program to help establish firmer financial footing that will protect the state’s safety net.”

Mayhew recognized that these changes are confusing and said it is important for people to know that the reductions will not begin until March 1.

“We are increasing staffing to be able to answer questions regarding the MSP because each person’s case is different,’’ Mayhew said. “In addition to our toll-free number [800-442-6003], the Office of Aging and Disability Services has a program that offers individual assessment and counseling free of charge. Maine’s Area Agencies on Aging is a valuable resource that can help seniors find out what other services may be available in their region and community that may offer additional support."

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