103°F
weather icon Clear

Possible privatization of Medicaid Services raises concerns

Legislation that would have privatized Medicaid services for the elderly, the blind and the disabled in Nevada died in the Assembly Ways and Means Committee, but the concept survived after being grafted onto a different bill.

Senate Bill 514 was introduced a day before the June 1 adjournment and was quickly approved by the Legislature.

Advocates who raised concerns about defunct Assembly Bill 310 say they are worried about SB514. It’s unclear how many people would be affected under the newly passed bill, which as of Friday hadn’t been signed by Gov. Brian Sandoval.

At this point, it’s not known whether the switch would be good or have a negative impact, said Barbara Paulsen, whose Boulder City church is part of the advocacy group Nevadans for the Common Good.

“If there’s a transition, it needs to be carefully planned,” Paulsen said Wednesday. “It’s a major decision and people need to be aware of it and need to have an understanding of the steps being taken and the rationale and ability to comment on them.”

Section 37 of SB514 enables the state to consider the possibility of providing long-term services and support to the blind, elderly and disabled through a managed care model. The governor would have to make a recommendation, which would then have to be approved by the state’s Interim Finance Committee.

Before submitting a request to the federal Centers for Medicare and Medicaid Services to amend the state’s Medicaid plan to allow the privatization of those Medicaid services, the state’s Department of Health and Human Services would have to submit an analysis of the fiscal impact for the transition to the Interim Finance Committee, according to the bill.

“SB514 says that the state needs to study the fiscal impact. Our concern is that they also study the impact (on) the people receiving those services,” said Robert Hoo, with Nevadans for the Common Good, a broad-based coalition of institutions in the Las Vegas area advocating for several issues including those affecting senior citizens.

It would not be acceptable if the move would cut back on services, he said. If the transfer maintains and improves services and saves the state money, then that’s a “win-win.”

“It’s critical that there is an opportunity for public input, public feedback,” Hoo added Wednesday.

Advocates for the blind, disabled and elderly are also concerned about the potential for disruption of care and whether managed care organizations have the capacity to provide needed services.

Nevada currently contracts with two national, for-profit managed care organizations, Amerigroup Community Care and Health Plan of Nevada, which is owned by UnitedHealthcare. Most of the current services are for families and children, not groups targeted in SB514.

The state also has a $130 million contract — 38 percent coming from the state’s general fund and 62 percent coming from the federal government — with McKesson Health Solutions to manage care for the sickest fee for services Medicaid beneficiaries, according to a copy of the contract summary.

Fee for services is a delivery system where health care providers are paid per service, such as an office visit, a test or a procedure, according to the Centers for Medicare and Medicaid Services.

The state also offers services through waivers administered by the state’s Division on Aging and Disability Services.

Managed care services are delivered through contracted arrangements.

As a current contractor, Amerigroup has experience serving Medicaid members, said Eric Lloyd, Amerigroup Nevada’s president.

“Amerigroup has significant experience effectively managing these populations in many other states across the country,” he said in a statement on Wednesday. “If the state of Nevada decides to move forward, we would like to continue the positive partnership we share with the state to provide the right care and service excellence for all new members.”

Representatives with Health Plan of Nevada didn’t respond to requests for interviews.

Advocates hope that if the state moves forward with the transfer of services into managed care, that it will follow the best practices and guidelines from the Centers for Medicare and Medicaid Services, said Lynn Hunsinger, director of professional services for Nevada Senior Services, which provides adult day care and other services.

Although about 19 other states have already made this move, Nevada’s social services infrastructure is vastly different, she added.

There’s fear that some of the state’s most vulnerable people could fall through the cracks.

“Services are lean, and in some ways, there are already gaps in services that community providers can’t meet,” she said Friday.

Nevada Assembly Majority Leader Paul Anderson, R-Las Vegas, sponsored AB310, but previously declined to be inter­viewed because he said his bill wasn’t going anywhere. When called again after the passage of SB514, Anderson didn’t comment.

The language in SB514 permits the state — but does not require it — to implement the idea, said Richard Whitley, interim director for the state’s Department of Health and Human Services.

“The enabling language … allows Nevada to evaluate the long-term services and supports systems in the state and select the best method for providing these valuable services,” he said in a statement on Thursday. “The process used to evaluate any proposed changes will be transparent.”

The evaluation will include input from consumers, providers of services, elected officials and state staff, among others.

“After a thorough review of the state’s long-term services and supports needs, recommendations will be provided to the governor and to the Interim Finance Committee,” he said.

Contact Yesenia Amaro at yamaro@reviewjournal.com or 702-383-0440. Follow @YeseniaAmaro on Twitter.

Don't miss the big stories. Like us on Facebook.
Politics Videos
Media's Double Standard On Incitement And Trump - Video
Over the weekend, an Elizabeth Warren-supporting socialist who opposed gun violence used a rifle to commit a mass murder in Dayton, Ohio. The media has downplayed that aspect of the tragedy.
Project Our Care Tour Kicks Off In Las Vegas
U.S. Rep. Dina Titus joined health care advocates and local residents as part of Protect Our Care’s nationwide bus tour kick off in Las Vegas on Monday, August 5, 2019. (Mat Luschek / Review-Journal)
Bernie Sanders talks about guns, response to El Paso shooting
Sen. Bernie Sanders spoke about his response and continued policy ideas about guns and gun control to the Review-Journal after a panel of other topics. (Rachel Aston/Las Vegas Review-Journal)
Pete Buttigieg On Gun Control And Climate Change - Video
Pete Buttigieg talks about his campaign for the 2020 election and how Nevada is a vision of what the future can be.
Beto O'Rourke speaks in Las Vegas
Presidential candidate Beto O'Rourke spoke to supporters at the East Las Vegas Community Center in Las Vegas, Thursday, Aug. 2, 2019. (Las Vegas Review-Journal)
Former Nevada Senate leader Kelvin Atkinson sentenced to prison
Former Nevada Senate Majority Leader Kelvin Atkinson, who pleaded guilty to misusing campaign funds, was sentenced to 27 months in prison on Thursday, July 18, 2019. (Mat Luschek/Las Vegas Review-Journal)
Trumps Strength is also a Weakness - Video
One of Donald Trump’s greatest strengths — his ability to shape national narratives — is also a great weakness.
Tax the Rich Bus Tour makes a stop in Las Vegas - Video
The Tax the Rich Bus has stopped in Las Vegas as part of its summer tour. (Las Vegas Review-Journal)
Assemblywoman Daniele Monroe-Moreno hosts BBQ - Video
Assembly Woman Daniele Monroe-Moreno hosts BBQ to bring the community together to hear about the candidates up for election and for people to gather and have fun.
Democrat Virtual Caucus - Video
Elizabeth Warren visits Las Vegas
Senator Elizabeth Warren made a campaign stop at the East Las Vegas Community Center on Tuesday July 2, 2019. (Mat Luschek / Review-Journal)
Aaron Ford Speaks About Bill AB431
AB431 is a bill sponsored by Nevada Assembly Speaker Jason Frierson to restore the right to vote for formerly incarcerated individuals. Attorney General Aaron Ford spoke at the AM&E Church in North Las Vegas about the bill, on Monday, July 1, 2019. (Mat Luschek/Las Vegas Review-Journal)
The Right Take: Biden's Racially Questionable Comments
Joe Biden has uttered racially charged statements for years. Now that he’s the frontrunner for the Democrat presidential nomination, he may finally face prolonged scrutiny for them.
Christopher Rufo Discusses Homelessness In The USA - VIDEO
Christopher Rufo discusses homelessness in the United States and how politicians can work to improve conditions for those with drug addictions.
Clark County 2019 Election Results - Video
The 2019 Elections wrap up in Clark County including an upset in the Boulder City Mayor race.
Olivia Diaz talks about her win in Ward 3 - VIDEO
Las Vegas City Councilwoman-elect Olivia Diaz talks about her election win in Ward 3 and what lies ahead for her.
Greene discusses Read by 3 and Opportunity Scholarships - VIDEO
The Nevada Legislative Session is over and the results are mixed for Nevada students, according to Tom Greene, Senior regional legislative director, Excel in Ed in Action.
Bernie Sanders visits Las Vegas
Sen. Bernie Sanders made a stop at Roy W. Martin middle school on Thursday, during his campaign trail.
THE LATEST