June 29, 2004
LEAVING NO PLAD BEHIND
Mississippi Medicaid was bleeding badly – doubling in cost over 5 years -- and changes had to be made. Our dilemma was this: How to keep the Medicaid program sustainable while making sure everyone had adequate health care coverage?
A part of the solution was to move 47,000 state Medicaid recipients who are also eligible for federal Medicare (6% of all recipients – called PLADs, or Poverty Level Aged and Disabled) off of Medicaid and onto Medicare alone. The state program would be strengthened; those who were eligible for both programs would be off Medicaid, but have new Medicare coverage available to them. This change was necessary and appropriate because Mississippi is not rich enough to pay for what the federal government already provides. The 6% who are being shifted to Medicare need and must get quality health care. This is how we plan to help them:
• Time to Transition
We are delaying the implementation of the shift from Medicaid to Medicare for PLADs beneficiaries – from July 1 to September 15, 2004 – meaning an additional 11 weeks of transition time. This extra time is needed so we can help PLADs recipients with the transition.
• Early Enrollment
We have received federal permission to allow Mississippi PLADs beneficiaries an exclusive advance enrollment opportunity for Medicare prescription drug cards and some patient assistance programs. The federal Medicaid agency, CMS, will allow those Mississippi Medicaid beneficiaries who will be shifted to Medicare to sign up in advance for their Medicare prescription drug cards – instead of having to wait until they are removed from the Medicaid program before they can sign up.
• Sign-Up Assistance
We will conduct a 77-day public education plan to contact all 47,000 PLADs beneficiaries to assist them with their enrollment in the correct prescription plans. We will help them sign up for and receive not only the Medicare benefits but also the tremendous benefits available under the Patients Assistance Programs, which make more than 1350 prescription drug programs available for free or no more than $15 per month. Every PLADs beneficiary is eligible for these benefits, but we know many of them need help in getting enrolled and served. We will use this delay to make sure they get it.
• Good News for At-Risk Beneficiaries
We have had positive waiver negotiations with federal officials about allowing 18,000 at-risk beneficiaries to remain on Medicaid. Now, with extra transition time, we are even more confident the waivers will be granted when the reforms go into effect on September 15.
Governor Haley Barbour
P.O. Box 139 Jackson, MS 39205
Phone: 601.359.3150 Fax: 601.359.3741