A Medicaid advisory panel assembled by Idaho Gov. Philip E. Batt has issued a report that recommends 88 wide-ranging reforms that would encourage recipients "to achieve self-sufficiency and independence."
Among the recommendations:
Establish Medicaid eligibility on a sliding income scale so recipients can receive benefits while holding jobs.
Encourage the use of preventive-care and wellness programs, including mandatory courses for those in Healthy Connections, the state's managed-care Medicaid program.
Require hospital emergency rooms to refer patients who don't need emergency treatment to other settings, with the referring physician and staff not held legally liable.
Remove loopholes that allow recipients to transfer assets to other family members in order to remain eligible and make financially viable next of kin who pay for care.
Exclude legal immigrants from receiving benefits.
Carve out and capitate mental health benefits.
Reform the various ways providers are reimbursed so as to encourage cost containment.
Establish a program to have families reimburse the state for prenatal and maternity care.
Eliminate most dental and audiology coverage for adults.
Many of the recommendations would require Medicaid waivers from HCFA. Others would require new laws to be passed by the Idaho Legislature as well as Congress.
The council also called for the establishment of a governance body to monitor progress in the implementation of reforms. Batt's office said it's reviewing the report and has no response yet.
Batt convened the Medicaid Reform Advisory Council last April to investigate problems within Idaho's Medicaid program, which costs state taxpayers $367 million a year and has seen rolls increase to nearly 85,000 this year from 33,000 in 1989. The panel of 17 Idaho lawmakers and private citizens held 35 public hearings throughout the state.