Medicaid Cost Containment, FY2009 - Kaiser State Health Facts

Medicaid Cost Containment Actions Taken by States, FY2009

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	Provider Payments	Pharmacy Controls	Benefit Reductions	Eligibility Cuts	Copays	Changes to Application and Renewal	LTC

United States	32+DC Yes	35 Yes	10 Yes	1 Yes	2 Yes	0 Yes	8 Yes

Alabama	Yes	Yes	No	No	No	No	Yes
Alaska	No	Yes	No	No	No	No	No
Arizona	Yes	No	No	No	No	No	No
Arkansas	Yes	No	No	No	No	No	No
California	Yes	Yes	No	No	No	No	No
Colorado	No	Yes	No	No	No	No	No
Connecticut	Yes	No	No	No	No	No	No
Delaware	Yes	Yes	No	No	No	No	No
District of Columbia	Yes	No	No	No	No	No	No
Florida	Yes	Yes	No	No	No	No	No
Georgia	Yes	No	No	No	No	No	No
Hawaii	No	No	No	No	No	No	No
Idaho	Yes	Yes	No	No	No	No	No
Illinois	No	Yes	No	No	No	No	No
Indiana	Yes	Yes	No	No	No	No	No
Iowa	No	No	No	No	No	No	Yes
Kansas	Yes	Yes	No	No	No	No	No
Kentucky	No	Yes	No	No	No	No	No
Louisiana	Yes	Yes	Yes	No	No	No	Yes
Maine	Yes	Yes	No	No	No	No	No
Maryland	No	No	No	No	No	No	No
Massachusetts	Yes	Yes	Yes	No	Yes	No	No
Michigan	Yes	Yes	Yes	No	No	No	Yes
Minnesota	Yes	Yes	No	No	No	No	No
Mississippi	No	No	No	No	Yes	No	No
Missouri	Yes	Yes	No	No	No	No	No
Montana	No	Yes	No	No	No	No	No
Nebraska	No	No	Yes	No	No	No	Yes
Nevada	Yes	No	Yes	No	No	No	Yes
New Hampshire	Yes	Yes	No	No	No	No	No
New Jersey	Yes	Yes	No	No	No	No	No
New Mexico	Yes	No	No	No	No	No	No
New York	Yes	Yes	No	No	No	No	Yes
North Carolina	Yes	Yes	No	No	No	No	No
North Dakota	No	No	No	No	No	No	No
Ohio	Yes	Yes	No	No	No	No	No
Oklahoma	Yes	Yes	Yes	No	No	No	No
Oregon	No	Yes	No	No	No	No	No
Pennsylvania	Yes	Yes	No	No	No	No	No
Rhode Island	Yes	Yes	Yes	Yes	No	No	No
South Carolina	Yes	Yes	No	No	No	No	No
South Dakota	No	No	No	No	No	No	No
Tennessee	Yes	No	Yes	No	No	No	No
Texas	Yes	Yes	No	No	No	No	No
Utah	Yes	Yes	Yes	No	No	No	No
Vermont	No	No	No	No	No	No	No
Virginia	No	Yes	Yes	No	No	No	No
Washington	Yes	Yes	No	No	No	No	No
West Virginia	No	Yes	No	No	No	No	No
Wisconsin	No	Yes	No	No	No	No	Yes
Wyoming	No	Yes	No	No	No	No	No

(show/hide notes)

Sources:

The Crunch Continues: An Update on Medicaid Spending, Coverage and Policy in the Midst of a Recession. Results from a 50-State Medicaid Budget Survey, State Fiscal Years 2009 and 2010 Appendix A-2. Kaiser Commission on Medicaid and the Uninsured, September 2009. Available at: http://www.kff.org/medicaid/7985.cfm.

Definitions:

Provider Payments: Provider payment rate change, which may involve a payment rate freeze or cut. Providers include physicians, inpatient hospitals, nursing homes and managed care organizations.
Pharmacy Controls: Pharmacy utilization or cost control initiatives including subjecting more drugs to prior authorization, implementing or expanding preferred drug lists, and seeking new or enhanced supplemental rebates.
Benefit Reductions: Benefits restrictions, reductions or eliminations.
Eligibility Cuts: Eligibility reductions or restrictions. This may involve changes to eligibility standards, application and renewal process, or premiums. Other actions restricting eligibility include increasing the asset transfer look-back period from three to five years, limiting countable prior medical bills to those incurred within three months of application, increasing the waiting period from six to nine months, and freezing enrollment.
Copays: New or higher copayments for services. In imposing copayments, states must comply with Federal Medicaid law, which specifies that copayments must be "nominal", generally defined as $3.00 or less per service. The law also provides exemptions so copayments cannot apply to certain services or certain eligibility groups such as children or pregnant women. Federal law requires that a provider must render a service regardless of whether the copayment is collected.
LTC: Cost containment initiatives for long term care and home and community based services programs.

Federal Fiscal Year: Unless otherwise noted, years proceeded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. For example, FY 2009 refers to the period from October 1, 2008 through September 30, 2009.

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