HCFA has approved a federal waiver allowing the state of West Virginia to begin implementing a managed-care system for Medi-caid recipients.
The system initially will be limited to about 95,000 recipients in 12 of West Virginia's 55 counties. It will be rolled out in the 12 initial counties from August through November, said R. Philip Shimer, director of Medicaid managed care in the state's health department.
In total, the state's Medicaid program has about 366,000 recipients. Its budget for the fiscal year that ends June 30 is $1.4 billion.
Shimer said five HMOs have expressed interest in contracting with the state to coordinate care for recipients in those 12 counties but no contracts have been signed to date. The program's goal is to offer Medicaid recipients a choice of at least two HMOs.
West Virginia Hospital Association President Steven Summer said the association supports the state's move into managed care and is "pleased" that HCFA finally approved the state's Medicaid waiver application. The state applied for its waiver last August and expected approval by the end of 1995.
But, like all hospital associations, the WVHA "has some concerns that the state continues to adequately fund the Medicaid program as it shifts to managed care," Summer said.
HCFA approved a two-year waiver on April 29, and it's effective July 1.