HealthNet Oversight Committee SFY-2018 Budget Update
Explore the detailed SFY-2018 budget update for the MO HealthNet Oversight Committee presented by Valerie Huhn, Acting Deputy Finance Director. The update covers various budget items, including Medicaid costs, pharmacy funding, managed care services, and more.
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Presentation Transcript
SFY-2018 BUDGET UPDATE FOR MO HEALTHNET OVERSIGHT COMMITTEE Presented by Valerie Huhn Acting Deputy Finance Director February 7, 2017
MO HealthNet Oversight Committee SFY-2018 Budget 2 Governor's Rec TAFP Total GR Total GR (in millions) $7,860.8 $1,400.9 $7,860.8 $1,400.9 SFY 2017 DSS MO HealthNet Core Budget SFY 2018 Major Budget Items Medicaid Cost to Continue Based on SFY-2018 ongoing need as reflected in SFY-2017 supplemental Pharmacy, Clawback, MORx, Physician, Dental, Nursing Facilities, NFFRA, Rehab & Specialty Services, NEMT, Hospital Care, FQHC, Show-Me Healthy Babies and Blind Medical Benefits appropriations GR Pickups To replace one-time funding from DYS retroactive claiming and increased federal CHIP earnings Pharmacy, Clawback , MORx, Physician, Premium Payments, Rehab & Specialty Services, Managed Care, Hospital Care, and Blind Pension Medical Benefits appropriations $282.5 $63.5 $0.0 $0.0 $113.0 $113.0 $113.0 $109.0
MO HealthNet Oversight Committee SFY-2018 Budget 3 Governor's Rec TAFP Total GR Total GR (in millions) SFY 2018 Major Budget Items Pharmacy PMPM Specialty Increase Funding for the ongoing inflation and utilization of specialty pharmaceuticals $79.3 $28.5 $0.0 $0.0 Pharmacy PMPM Non-Specialty Increase Funding for the ongoing inflation and utilization of non-specialty pharmaceuticals $0.0 $0.0 $0.0 $0.0 Pharmacy - Clawback Increase Funding for the increase in Medicare Part D clawback rates and utilization $17.4 $17.4 $17.4 $17.4 Premium Payments Increase Funding for the increase in Medicare Part B rates and utilization $17.1 $5.9 $17.1 $5.9
MO HealthNet Oversight Committee SFY-2018 Budget 4 Governor's Rec TAFP Total GR Total GR (in millions) SFY 2018 Major Budget Items Managed Care Actuarial Increase Funding for Managed Care medical, delivery and Neonatal Intensive Care Unit services to ensure that managed care payments are actuarially sound $20.9 $7.4 $20.9 $7.4 NEMT Actuarial Increase Funding for NEMT rates to ensure payments are actuarially sound $2.5 $0.9 $2.5 $0.9 Statewide Managed Care Transition Funding for one month SFY17 capitation payment to be paid in arrears and Fee-For-Service claim run-out from SFY17 which will be paid in SFY18 $99.5 $35.3 $41.2 $14.6 Hospice Rate Increase Funding for annual hospice rate increase as established by Medicare. The MO HealthNet hospice rates are calculated based on the annual hospice rates established under Medicare. $0.3 $0.1 $0.3 $0.1
MO HealthNet Oversight Committee SFY-2018 Budget 5 Governor's Rec Total TAFP GR Total GR (in millions) SFY 2018 Major Budget Items HB 1565 Asset Limit Increase The bill raises the MO HealthNet asset limits for MO HealthNet permanent and totally disabled claimants, MO HealthNet blind claimants, and MO HealthNet aged claimants from $1,000 to $2,000 for individuals and $2,000 to $4,000 for married couples in 2018. Other NDIs: $72.8 $15.7 $43.5 $5.2 Other Fund Offset (Managed Care) $17.5 $50.0 $1.3 $1.5 $20.3 $0.0 $0.0 $0.0 $0.0 $0.0 $0.4 $4.7 $0.0 $0.0 $17.5 $55.0 $1.3 $1.5 $0.0 $0.1 $8.1 $0.0 $0.0 $0.0 $0.4 $0.0 $0.0 $0.0 Tobacco Fund Swap (Managed Care)-Governor s Amendment FRA Health Home Authority MMIS Contract Extensions MMIS Replacement Medicaid ER Reduction Program Nursing Facility Rate Increase from Senior Services Protection Fund Level of Care From 24-21 points from Senior Services Protection Fund $0.0 $0.0 $3.0 $0.0
MO HealthNet Oversight Committee SFY-2018 Budget 6 Governor's Rec Total TAFP GR Total GR (in millions) SFY 2018 Major Core Cuts Rollback of Rate Increases Physician, Nursing , Dental, Home Health, Rehab & Specialty, Complex Rehab, and Health Homes Program Reductions and Eliminations ($60.6) ($25.1) ($30.3) ($4.5) ($4.0) ($0.5) ($131.6) ($0.8) ($0.3) ($2.0) ($1.6) ($21.1) ($4.0) ($0.5) ($30.9) ($0.4) ($0.2) ($0.2) ($0.6) ($10.8) ($12.5) ($145.6) ($0.6) ($0.2) ($2.0) ($0.2) ($21.1) ($10.8) ($12.5) ($35.9) ($0.3) ($0.1) ($0.2) ($0.1) Women's Health Services (transferred to DHSS) MORx Program Pharmacy OPI/BPM savings is difference Monitoring Program Pager Pilot Program Regional Care Coordination CHAPS $0 $0 Various empty or excess authority FMAP (net of NDI and core changes) $0 ($68.3) $0 ($68.3) $8,322.4 $1,505.0 $8,005.4 $1,343.1 Total FY 2018 DSS MO HealthNet Budget (without transfer appropriations)
MO HealthNet Oversight Committee Revenue Update FY 2017 Consensus Revenue Estimate 4.1% Growth - $9,633.7B FY 2017 Revised Consensus Revenue Estimate 3.0% Growth - $9,053B FY 2016 ended at .89% growth or $8,786.8B FY 2018 Consensus Revenue Estimate 3.8% Growth - $9,398B FY 2017 Actual Revenue Growth - April Collections Increased 3.1% for the year. From $7.4B to $7.6B 7
