By fitsnews – February 23, 2010
By FITSNews || A lawmaker with considerable influence over health care policy in South Carolina is trying to eliminate the “fee for service” model for Medicaid recipients in the Palmetto State – a move he says will save taxpayers $30 million over the next two years.
Rep. Tracy Edge (R-Myrtle Beach) has unveiled a budget amendment that would require the S.C. Department of Health and Human Services to modify its “Healthy Connections Choices” program so that all enrollees would choose between a Medical Home or managed care provider.
Seventy percent of Medicaid recipients are already in a managed care situation, Edge says.
“Instead of hospitals billing for needless tests, they would have to receive pre-authorization,” Edge told FITS.
Needless to say, hospitals are vehemently opposed to Edge’s amendment, which is scheduled to be debated on Wednesday.
If hospitals don’t play ball, though, one source told FITS that Edge is poised to cut their rates – although he declined to discuss that possibility with us.
Edge did say that at the conclusion of the budget debate next month he was planning on exploring “every option on the table” to cut costs, including a Medicaid voucher proposal.
“It’s time for bold plans,” Edge said.
Hospital reimbursement rates for Medicaid have increased dramatically in recent years, although one lobbyist for the health care industry said Edge would be unwise to pursue slashing them.
“That would start a war,” the lobbyist said. “He doesn’t want to go there.”
