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This column features selected short items about state health care policy.
FRANKFORT—A new state law that requires small children to get an eye examination is aimed at preparing youngsters for school.
But for some uninsured Kentucky parents, paying for that exam isn’t easy.
The exams, which sometimes can cost around $75, are covered by most family health insurance plans.
Now the state is willing to help families who don't have insurance. The Cabinet for Health Services announced that $150,000 is available to pay for the eye examinations, which became mandatory in July for children entering Kentucky public schools for the first time.
Families are eligible for assistance if they don’t qualify for Medicaid or the Kentucky Children's Health Insurance Program, and if their income is between 200% and 250% of the federal poverty level. For a family of three, that would be an annual income between $28,300 and $35,375.
—Herald-Leader, Lexington, KY, Jan. 25
DES MOINES, IA—State officials say they are trying to negotiate a deal with Iowa's hospitals to recover millions of tax dollars paid to the hospitals in error.
The Iowa Department of Human Services recently notified the Iowa Hospital Association that the state inadvertently exceeded federal spending limits on Medicaid payments to hospitals for inpatient services.
According to the association, the state estimates the potential overpayment for last year alone is $10 million to $11 million.
That's just the beginning. The state has concluded that overpayments of an undetermined size were made annually from 1996 through 1999, and that payments for outpatient services at University Hospitals in Iowa City exceeded federal limits in 1996, 1997, and 2000.
State officials are working with the Health Care Financing Administration, which oversees Medicaid spending, to resolve the matter. So far, no one at the Department of Human Services is willing to say how much taxpayer money may have been misspent through the overpayments.
Jessie Rasmussen, director for the Department of Human Services, said that’s because the state and the hospitals are trying to agree on how much is owed and how the money can be repaid.
"We’ve got some numbers, but we’re trying to be careful because we want to work with the hospital association," she said.
"We’re not out to set up problems for the hospitals. They serve our people, and we don’t want to damage that. So we’re going to want to negotiate with the hospitals about reasonable payback periods for them, and then we’ll want to take that into our negotiations with the association," adds Ms. Rasmussen.
—Des Moines Register, Jan. 25
WASHINGTON, DC—State governments are spending billions of dollars to pay for the consequences of drug and alcohol abuse while giving scant attention to prevention and treatment efforts, a private research center reported.
The group called for a "revolution" in spending priorities, showing that states spend an average of 96 cents of every dollar in their substance-abuse budgets to cover cost increases that drug and alcohol abusers bring to law enforcement, social services, and health care. Meanwhile, just 4 cents in each dollar go to drug abuse prevention, treatment or research.
Altogether, states spent $81.3 billion — more than 13% of their combined total operating budgets of $620 billion — covering the damage wrought by drug addiction on public programs in 1998. Alcohol was the biggest drain, accounting for $9.2 billion in state spending.
"It’s an incredibly lopsided way to deal with the problem of substance abuse. We need a revolution in the way governors and state legislators look at this problem," said Joseph A. Califano Jr., president of the National Center on Addiction and Substance Abuse at Columbia University in New York City.
The center spent three years analyzing spending in 45 states plus the District of Columbia and Puerto Rico to generate the report.
Figures were even more lopsided for the cost of substance abuse among children. There, the report found that only $1 out of every $113 spent on juvenile justice, child welfare, and other areas goes to prevention and treatment.
The center used studies linking substance abuse to public spending in order to estimate the impact of drug use on government budgets in each state.
The numbers do not include the federal share of education, welfare programs, or Medicaid. They also do not account for the effect of substance abuse on private insurance costs and lost workplace productivity.
—Reuters Health, Jan. 29
PROVIDENCE, RI—Christine Ferguson, state human services director — a candidate for a top health care post in the new Bush administration — recently went before one of Rhode Island’s legislative panels to explain why her agency is overspending its budget for this year by $19.5 million in state and federal dollars.
At Ms. Ferguson’s request, U.S. Sen. Lincoln Chafee (R-RI) has written to Vice President Richard Cheney recommending Ferguson for the top position in the Health Care Financing Administration (HCFA).
"Christy offers the new administration a wealth of experience in health care and human services," Mr. Chafee wrote of Ms. Ferguson, who was a key staff member to his father, the late Sen. John H. Chafee, during his unsuccessful efforts to forge a compromise on health care reform in the early years of the Clinton administration.
Her prospects for a job in the Bush administration remain uncertain.
Ferguson was casting blame at the Clinton-era HCFA for her state agency’s inability to impose some of the cost-controls that lawmakers here approved last year in an effort to rein in the exploding costs of RIte Care, the state’s much-heralded health insurance program for low- to middle -income families with children.
—Providence Journal, Jan. 26