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Wisconsin Medicaid proposal includes drug tests, premiums and other regional news

MIDWEST: Wisconsin Medicaid proposal includes drug tests, premiums

Wisconsin last week unveiled plans to overhaul Medicaid by requiring members to pay insurance premiums and undergo a drug screening. If the latter is approved it would become the first state in the nation to do so. State health officials said they will submit a waiver request to the CMS on May 26, following public comment.

The proposal looks a lot like the controversial Healthy Indiana 2.0. Indiana state officials are accused of using misleading and inaccurate information to boost the benefits of their program and justify an extension and additional federal funding.

In Wisconsin's proposal, childless adults would pay monthly premiums ranging from $1 to $10 per household based on income. Those with household incomes up to 20% of the federal poverty level would be exempt from paying a premium.

Members who underwent a health risk assessment and engaged in “healthy behaviors” would also receive breaks, though the requirements for those behaviors weren't outlined.

Wisconsin's drug testing would direct members who test positive to treatment. Members who refuse to take the test couldn't receive benefits for six months.

Wisconsin Republican Gov. Scott Walker, who has refused to expand Medicaid, sent a public letter to President Donald Trump in December asking for permission to drug test applicants on food stamps.

In 2015, Walker's administration sued to force the Obama administration to approve drug testing for those applicants. The court tossed out the lawsuit.

Almost 797,000 people are enrolled in Wisconsin's Medicaid program. Of those, 147,000 are childless adults who would be affected by these proposals. —Shelby Livingston


NORTHEAST: Partners HealthCare to acquire Care New England

Boston-based integrated system Partners HealthCare will acquire Care New England Health System of Providence, R.I.

The two not-for-profit systems last week said they have signed a letter of intent to negotiate a deal just a few months after Care New England's proposed merger with New Bedford, Mass.-based Southcoast Health System fell through.

The deal with Partners would include Care New England-owned facilities Kent Hospital in Warwick, R.I.; Women & Infants Hospital of Rhode Island in Providence; VNA of Care New England in Warwick; Butler Hospital in Providence; and the Providence Center in several locations across the state.

Negotiations are just beginning and it could take two to three months before a definitive agreement is reached, said Care New England President Dennis Keefe. —Shelby Livingston


SOUTH: CMS lifts termination threat against Greenville Memorial

The CMS has lifted the threat of canceling Medicare and Medicaid contracts at Greenville (S.C.) Memorial Hospital after the hospital made needed improvements to emergency room processes and staffing.

Greenville Memorial could have lost about $500 million in annual patient revenue from the CMS if the contracts had been revoked.

The hospital was investigated by state regulators in March after a 48-year-old Greenville man who allegedly became combative in the ER died when he was restrained by security on a gurney. Their findings led to the CMS termination notice. —Dave Barkholz


SOUTH: Failed S.C. co-op sues feds over reinsurance payments

Consumers' Choice Health Insurance Co., the failed insurance co-op for South Carolina, has sued the federal government, alleging it's illegally trying to collect loan repayments from the co-op.

Consumers' Choice claims the feds owe it $37 million in reinsurance payments under the Affordable Care Act. An ACA provision requires the CMS to abide by state laws when it seeks repayment of loans from co-ops. South Carolina law doesn't allow lenders to offset debt from loans until they fulfill their own financial obligations.

The federal government appropriated billions of dollars to fund co-ops across the country. South Carolina received an $18 million startup loan and a $68 million solvency loan to form Consumers' Choice. —Maria Castellucci


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