January 3

Medicaid needs $10 million more, Maine panel says

A state commission also proposes studying challenges facing long-term care in the state.

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

A Maine commission that studied long-term care facilities issued a final report Thursday calling for an additional $10 million in Medicaid funding in the coming fiscal year to help offset chronic reimbursement shortfalls for nursing homes and assisted-living centers.

The report from the Commission to Study Long-Term Care Facilities also includes recommendations and proposed legislation for further study of the various challenges facing long-term care because of Maine’s rapidly aging population.

The commission found that MaineCare, the state’s Medicaid program, underfunded allowable nursing home and assisted-living costs by $24 million in 2009, $22.5 million in 2010 and $29.4 million in 2011, according to BerryDunn of Portland, a consulting firm that specializes in Medicaid and reimbursement. The state paid $271.5 million in MaineCare reimbursements in 2011.

The commission also learned that delayed auditing of MaineCare cost reports by the Department of Health and Human Services intensifies financial pressure on nursing homes and assisted-living facilities. In late October, the DHHS had 174 cost reports from 2010 through 2012 that were waiting to be audited and accounted for about $8 million in unpaid MaineCare reimbursements.

In addition, an auditor’s review showed that problems with DHHS computer and accounting systems caused errors in payments to nursing homes and assisted-living facilities, reducing the amount of state and federal money available for government use by about $27 million at any given time.

The proposed legislation would direct the DHHS to correct the funding errors and fix the computer problems.

The bill also would create the Commission to Continue the Study of Long-Term Care Facilities and the Blue Ribbon Commission on Long-Term Care. The latter would review the state’s plan to provide long-term care, including less-expensive and often-preferred in-home care, and draft a new plan to present to the Legislature.

Formed by the Legislature, the 11-member commission met five times in the fall, gathering information from service providers and advocates for the elderly.

Long-term care challenges are especially acute in Maine, which is the oldest state based on median age (43.5 years) and the second-oldest based on proportion of people age 65 and older (17 percent), according to the U.S. Census. Florida is No. 1, with 18.2 percent.

Maine also has the highest proportion of baby boomers – 29 percent of its 1.3 million residents were born in the years from 1946 to 1964.

The Portland Press Herald/Maine Sunday Telegram is examining various impacts of Maine’s rapidly aging population in a special investigative series, “The Challenge of Our Age.”

Kelley Bouchard can be contacted at 791-6328 or at:

kbouchard@pressherald.com

Twitter: @KelleyBouchard

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