AUGUSTA, Maine-The Maine Department of Human Services plans to offer hospice-care coverage to the state's Medicaid recipients beginning this summer and recently extended its Medicaid managed-care program statewide.
The plan to cover hospice care was based on the recommendation of state legislators, who earlier this month found a gap in Medicaid services while debating a bill to legalize physician-assisted suicide. Legislators opposed the bill, instead urging the state to focus on providing reliable hospice services for the poor.
Maine is one of eight states that do not provide hospice coverage to Medicaid recipients, forcing them to pay for it themselves. State residents age 65 and older already are eligible for hospice care through Medicare.
Christine Zukas-Lessard, director of policy development, said DHS is in the early stages of drafting rules that will allow it to begin covering hospice care this summer.
The move will affect hundreds of terminally ill patients in the state who are not old enough to qualify for Medicare or are unable to afford private insurance. The state has 158,000 Medicaid recipients.
In published reports, Francis Finnegan, director of medical services for DHS, said the state should be able to offer the coverage without increasing its $1 billion annual budget.
DHS extended its Medicaid managed-care program to all state recipients, effective March 1.
Medicaid recipients now are able to enroll in an HMO that NYLCare, a subsidiary of New York Life, has offered under contract with DHS since May 1997.
Zukas-Lessard said DHS had expected to enroll 12,000 Medicaid recipients in the HMO the first year through a mandatory program. But the program remains voluntary because it doesn't offer a choice of HMOs-a federal requirement for mandatory HMO enrollment.
Only about 5,000 Medicaid recipients are enrolled in NYLCare's HMO at this time, Zukas-Lessard said. "We're at about 8% of potential enrollees in seven counties; and unless we go into new counties, we're not going to get up to 12,000 enrollees (on a voluntary basis)," she said.