Planned Medicaid cuts hit dental, home care
More than a million low-income Massachusetts residents covered by Medicaid would lose coverage for dentures and some other oral care, be required to pay more for visits to certain doctors and receive prior approval for some expensive psychiatric medications under a plan proposed by the Patrick administration to narrow a $307 million shortfall in the state’s MassHealth program. The plan would also eliminate Personal Care Attendant coverage for those who have approval for less than 15 hours a week of service.
Some of the PROPOSED MassHealth Changes:
- Adult dental care- adult members would no longer receive dentures or other oral care except for cleanings, X-rays, and emergency services. That change alone is expected to save about $15 million this fiscal year, said interim Medicaid director Terence Dougherty.
- Personal care attendants for patients requiring the in-home aides less than 15 hours a week would be cut.
- Copayments for office visits to specialists would double, to $6.
- Pharmacy copayments- most patients would pay about $1 more for generic medications, and copayments for brand name drugs would jump from $3 to $5 for people who make more than about $15,000 a year.
- Mental Health drug prior-approval- mental health patients would be required to get prior approval before filling prescriptions for certain brand name antidepressants and other psychiatric medications if comparable generic drugs are available.
- Nursing Home Pre-Screening elimination- proposal to eliminate all of the funding for nursing home pre-screening, a $2.5 million cut.
Dougherty said the administration’s strategy was to avoid, as much as possible, eliminating programs and instead to reduce services across a broad spectrum. “I think the very design the governor put out to us was to ensure that necessary services remain intact and that we don’t outright eliminate things,’’ said Dougherty. “That’s about the only solace I can offer anybody.’’
Dougherty said the recession and widespread job losses have swelled the number of residents seeking assistance through the Medicaid program by more than the Patrick administration anticipated when it put together this year’s budget proposal a year ago. Today, more than 1.2 million residents are receiving Medicaid assistance, up 115,000 from a year ago. At the same time, the administration is struggling to plug a $600 million gap in the rest of the state budget.
Dougherty said the proposed increases in patient copayments, cuts in dental services, and the elimination of the nursing home prescreening probably will not go into effect until April because state lawmakers must first approve the measures and then hold public hearings.
Advocates for the poor, disabled, and elderly criticized the proposals, saying the administration was attempting to balance the budget on the backs of the state’s most vulnerable citizens. The cuts to dental care and in-home health services, they said, would be especially painful.
“Dentures aren’t a luxury,’’ said AARP Massachusetts state director Deborah Banda. “And if you are someone who relies on a personal care attendant to help you get out of bed or to the bathroom, that’s not a luxury either. “Before the Commonwealth takes one more basic necessity away from our most vulnerable residents,’’ she said, “let’s exhaust every other option.’’
Also drawing stinging reaction was the administration’s proposal to eliminate all of the funding for nursing home pre-screening, a cut that advocates said could force many more seniors into nursing homes. The counseling explores other options that can help people stay at home longer, such as personal care services. “This program is a money saver, because it diverts people from nursing homes,’’ said Al Norman, executive director of Mass Home Care.
Mike Fadel, vice president of 1199 SEIU, a labor union representing many health care workers, said, “As caregivers, our members see first-hand how cuts of this nature threaten the health, safety, and independence of seniors and people with disabilities across the Commonwealth.’’
-From “Planned Medicaid cuts hit dental, home care; Patrick must trim $117m; higher copays expected” By Kay Lazar, The Boston Globe, November 14, 2009 , http://www.boston.com/news/health/articles/2009/11/14/planned_medicaid_cuts_hit_dental_home_care/ retrieved 11/16/09.
11/09