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Medicaid Managed Care Delay Could Leave $15M Hole In DHHS Budget

Implementation of the state’s Medicaid managed care program continues to stall.

Further delays could lead to a multimillion dollar budget shortfall in the state’s largest department.

Department of Health and Human Services Commissioner Nick Toumpas projects a $9 million shortfall in his budget for the rest of this fiscal year.

As he explained to members of the House Finance Committee Thursday, that’s because savings from the managed care program were assumed in the department’s budget.

“If we do not implement care management for the balance of the year, that will rise up to $15 million.”

The managed care program was supposed to roll out last July, but hospitals and community mental health centers are disputing reimbursement rates.

Toumpas says there needs to be an adequate network of provider groups before the program can go live.

“Absent contracts between the managed care organizations and these provider groups, we will not be able to move forward on this.”

Toumpas also says Medicaid expansion is not feasible without the managed care program.