Lawmakers OK Cost Savings, Physician Rate Boost for Medicaid

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Nevada lawmakers charged with reviewing the state's Health and Human Services Department budget voted Wednesday for an $8 million cost-saving program, but didn't go with a full physician rate increase for Medicaid initially proposed by the governor.

Under the plan approved, the state would spend $17.2 million to pay doctors who serve Medicaid patients 90 percent of the 2007 federal Medicare rate, with 100 percent reimbursement for some specialties. Currently, doctors are being paid at 85 percent of 2002 rates for Medicare.

That moves saves $10 million over an initial budget plan, which recommended a higher increase. More money will be saved by delaying
the rate change until fiscal year 2009.

Lawmakers had concerns that even with a rate increase, it would be hard for Medicaid to retain doctors who are tired of the paperwork and delays in payment.

"We've got physicians in our state that are not going to be taking these patients because they just flat can't afford it. And we've got to do everything we can to help them. ... The fact that we don't give it (the payments) to them in a timely manner is also another slap to the doctors," said Sen. Barbara Cegavske, R-Las Vegas.

Chuck Duarte, administrator of the Division of Health Care Financing and Policy, said those issues had mostly been resolved since an electronic payment system went into effect. He said payments are now going out within 14 days of receipt of a claim.

Duarte also said Nevada ranks fourth in the nation for how much it pays physicians for Medicaid services.

Lawmakers also approved an $8 million cost-saving package that was built into Gov. Jim Gibbons budget, despite doubts that the savings would pan out.

The savings would come from better health care management for some children, elderly and disabled people. Also, a program to provide dental care to pregnant women is expected to save money by reducing premature births.

Lawmakers were told by legislative staff there's no proof the program will work.

Assemblywoman Sheila Leslie, D-Reno, said she was frustrated because the savings were already built into the budget, meaning lawmakers would have to find more money if they didn't approve the

Senate Majority Leader Bill Raggio, R-Reno, ended the debate by pointing out that the Legislature asked the division to come up with some savings scenarios.

"They have responded as adequately as possible. They can't guarantee any of this. But they've done what they should have done," Raggio said.

(Copyright 2007 by The Associated Press. All Rights Reserved.)