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The Raleigh News and Observer reports that today Governor Perdue, having looked over the revenue collections from April 15, has decided that the 2008-2009 deficit is about a billion dollars worse than feared and has ordered that all state workers will have their annual pay reduced ½ % , including judges, legislators and administrative personnel. Also, there will be unpaid time off – furloughs. This is just to get through the end of fiscal 2008-2009.
It appears ever more likely that the $55 million (or perhaps more) in cuts to the PCS program for the next two fiscal years will be implemented. This makes it imperative for Home Care agencies to get efficient.
Wednesday, April 29, 2009
Wednesday, April 22, 2009
Changes Coming for PDN Providers
North Carolina Home Care agencies providing Medicaid Private Duty Nursing services should check out the new Proposed Clinical Policy 3E for PDN services, available on DMA’s website here.
Among the changes is a limitation in total daily hours of service to 16 hrs per day, with the possibility of added hours in exceptional circumstances. [As you may be aware, this change is in the current Senate approved version of the 2009-2010 North Carolina Budget]. Visit the DMA website and let them know your comments.
Among the changes is a limitation in total daily hours of service to 16 hrs per day, with the possibility of added hours in exceptional circumstances. [As you may be aware, this change is in the current Senate approved version of the 2009-2010 North Carolina Budget]. Visit the DMA website and let them know your comments.
Tuesday, April 21, 2009
North Carolina Budget Update
Budget concerns continue to rise for North Carolina Home Care agencies. A review of the Senate approved budget for fiscal year 2009-2010 reveals that the Senate proposal – the latest version – is to cut $55 million from the Personal Care Services program during the next fiscal year by beginning reductions on October 1, 2009. This is referred to by the Legislature as a “15% cut” – meaning that 55 million is about 15% of the cost of the whole program for the fiscal year. That’s a big pill to swallow.
But is it really only a cut of 15%? In order to save $55 million in the nine months remaining of the fiscal year after October 1, no money would be saved from July 1 to September 30th. Spending would presumably continue at the current higher rate until October 1, 2009. Then, the $55 million would be cut from the $225 million of funding remaining for the year. This means that for the last nine months of the year, the Personal Care program would have to be cut 24.4%, not 15%. Plainly, this can’t be accomplished via a rate cut, (which would mean reducing reimbursement rates to about $11.10.) More likely, DMA will have to look to a mix or combination of other means – such as prior authorization, tightening scoring rules, and reduce the number of hours per month – to limit costs. For example, if DMA implemented a 25% reduction in hours per month, recipients now getting 60 hours per month of PCS services would be limited to about 45 hours per month. We think this could be among the most significant challenges providers will face in the coming year. What to do? First, providers need to be active in supporting the efforts of the North Carolina Association for Home and Hospice Care, which has a great track record and has been proven very effective in advancing the interests of personal care recipients as well as providers. Second, we suggest you go over your internal operating budget and decide how you would accommodate a reduction in PCS Medicaid hours of 20 - 25%. If you would like some help, let us know.
But is it really only a cut of 15%? In order to save $55 million in the nine months remaining of the fiscal year after October 1, no money would be saved from July 1 to September 30th. Spending would presumably continue at the current higher rate until October 1, 2009. Then, the $55 million would be cut from the $225 million of funding remaining for the year. This means that for the last nine months of the year, the Personal Care program would have to be cut 24.4%, not 15%. Plainly, this can’t be accomplished via a rate cut, (which would mean reducing reimbursement rates to about $11.10.) More likely, DMA will have to look to a mix or combination of other means – such as prior authorization, tightening scoring rules, and reduce the number of hours per month – to limit costs. For example, if DMA implemented a 25% reduction in hours per month, recipients now getting 60 hours per month of PCS services would be limited to about 45 hours per month. We think this could be among the most significant challenges providers will face in the coming year. What to do? First, providers need to be active in supporting the efforts of the North Carolina Association for Home and Hospice Care, which has a great track record and has been proven very effective in advancing the interests of personal care recipients as well as providers. Second, we suggest you go over your internal operating budget and decide how you would accommodate a reduction in PCS Medicaid hours of 20 - 25%. If you would like some help, let us know.
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