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Medicaid up for big debates at Mississippi Capitol in 2018

Mississippi legislators in 2018 are expected to bicker over Medicaid, a government health insurance program that consumes a large portion of the state budget and covers about 1 in every 4 residents.

The program comes up for a thorough review every few years, and 2018 is one of them.

Legislators could discuss a wide range of issues, including managed-care contracts with private companies.

Top lawmakers said the House and Senate could even discuss details that affect Medicaid recipients’ daily lives. That would include whether to reconsider the limits on the number of prescriptions that can be filled and the number of doctors’ office visits that can be made by those who are not enrolled in managed care.

Most Medicaid recipients are in managed care , and supporters say it is designed to control costs by emphasizing preventative care and by trying to steer people away from expensive trips to the emergency room for illnesses that are better treated in nonemergency settings. However, critics say managed care creates another layer of bureaucracy for health care providers.

“The complaint with managed care is a complaint with insurance. It’s how the billing is done and things like that,” said House Medicaid Committee Chairman Chris Brown, a Republican from Nettleton. “Pretty much the same complaints they have with any insurance.”

A Medicaid medical care advisory committee of physicians and health care administrators met several times during 2017 and gave legislators a list of recommendations in mid-December. It said, among other things, that the Division of Medicaid should give health providers more information about how to deal with documents required by managed care companies. It also said the two Medicaid managed care companies should be consistent in what they require from providers.

Senate Medicaid Committee Chairman Brice Wiggins, a Republican from Pascagoula, said lawmakers are aware of providers’ frustrations.

“The Legislature, to this point, is committed to managed care,” Wiggins said. “We’re only a couple years into the managed care program. …. When you do something this big, there’s going to be issues, and so we need to try to address those.”

The state-funded part of Medicaid budget was set at about $920 million for the year that started July 1 – a slight decrease from the previous year. Program leaders are requesting an additional $47 million to cover costs through June 30.

About 707,000 of Mississippi’s nearly 3 million residents are enrolled in Medicaid, and the program makes up about one-sixth of the overall state budget.

Republican Rep. John Read of Gautier, chairman of the House Appropriations Committee, said the midyear funding request for Medicaid could go up or down, depending on the use of services the next few months: the number of prescriptions filled, the number of emergency room visits, and other variables.

“It’s a moving target,” Read said of the Medicaid budget.

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