77°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
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.
Kamala Harris campaigns in Las Vegas
Democratic Sen. Kamala Harris castigated President Donald Trump’s merit-based immigration plan, saying it was “short-sighted” and overlooked the cultural significance of family, during a campaign stop in Las Vegas. “We cannot allow people to start parsing and pointing fingers and creating hierarchies among immigrants,” Harris told Asian Pacific Islander leaders at a Chinatown restaurant, one of two appearances she made Thursday.
The Right Take New Education Funding Plan - VIDEO
On Monday, Senate Education Committee chair Mo Denis, D-Las Vegas, released a new education funding formula. For years, many Democrat politicians have criticized the current education funding formula, called the Nevada Plan. They claim it’s old and outdated. Their biggest beef is that it doesn’t allocate more money for students who are English Language Learners or live in poverty. The theory is that it’s harder to educate those students and so they need additional services, which costs additional money.
Kamala Harris campaigns in Nevada
California Senator Kamala Harris meets with One APIA Nevada, a nonprofit organization that advocates for policies empowering Asian Pacific Islander Nevadans. (Michael Quine/Las Vegas Review-Journal)
Ben Carson talks housing (Audio only)
Ben Carson discusses housing with the Review-Journal editorial board on Thursday. (Audio only)
Ben Carson visits the RJ (Full Audio Only)
Ben Carson discusses housing with the Review-Journal editorial board on Thursday. (Audio only)
Former Vice President Joe Biden campaigns in Nevada
After campaigning at the International Union of Painters and Allied Trades District Council 16 in Henderson, former Vice President Joe Biden spoke with the Review-Journal.
Student serenades Mayor Carolyn Goodman at swearing in
Students from the school she founded, The Meadows School, serenaded Las Vegas Mayor Carolyn Goodman during a swearing in ceremony for her third and final term. (K.M. Cannon/Las Vegas Review-Journal) @KMCannonPhoto
Al Gore Speaks At UNLV About Climate Change - Video
Former Vice President of the United States Al Gore talks to an audience at UNLV about the effects of Climate change and how to switch to renewable sources of energy.
Forum on Wages and Working People Highlights - VIDEO
Presidential candidates Elizabeth Warren, Beto O'Rourke, Kamala Harris, Amy Klobuchar, Julian Castro, and John Hickenlooper speak in Las Vegas, Nevada.
Nevada Politics Today Valerie Weber - VIDEO
Valerie Weber sits down with Victor Joecks to discuss her policies and why she is running for Ward 2 of the Las Vegas City Council.
Cory Booker speaks at UNLV
US Senator Cory Booker speaks at UNLV during a Young Democrats meet and greet on Thursday, April 18, 2019. (Mat Luschek / Review-Journal)
May-Brown describes why some with disabilities need the subminimum wage - VIDEO
Eliminating the subminimum wage will end training and work opportunities for some members of the disabled community. Instead of doing something productive, they would be relegated to adult day care. That’s according to Tracy May-Brown, Opportunity Village’s director of advocacy, board and government relations.
Commission’s decision will delay Red Rock Canyon development
The Clark County Commission Wednesday rejected a developer’s request to approve a preliminary plan for 3,000 homes overlooking Red Rock Canyon before a federal agency grants permission for a roadway leading to the site.
Clark County commissioner calls on landlords to bring properties up to code
Clark County Commissioner Tick Segerblom has called on landlords in older parts of the valley to bring their properties up to code and keep them well-maintained or face the prospect of inspections, fines and citations. (K.M. Cannon/Las Vegas Review-Journal) @KMCannonPhoto
Harry Reid speaks out against anti-Semitism
Unnerved by the rise in anti-Semitic hate speech and the general pervasiveness of bigotry, including in Nevada, former U.S. Sen. Harry Reid organized an educational forum at UNLV on Thursday as part of his call to unite people against it. (Shea Johnson/Las Vegas Review-Journal)
President Trump speaks to the Republican Jewish Coalition in Las Vegas
President Donald Trump spoke at the Republican Jewish Coalition’s National Leadership Meeting in Las Vegas and updated on Israeli relations. (Heidi Fang/Las Vegas Review-Journal)
Trump says border wall will have 'hundreds of miles' built by end of next year
President Donald Trump spoke at the Republican Jewish Coalition’s National Leadership Meeting in Las Vegas and discussed the progress of the border wall and the current relations there. (Heidi Fang/Las Vegas Review-Journal)
Protesters disrupt Trump's speech
Just as President Donald Trump started to make his opening remarks during his appearance at the Republican Jewish Coalition’s National Leadership Meeting, protesters disrupted his speech. (Heidi Fang/Las Vegas Review-Journal)
Roerink On The Problems With Taking Water From Eastern Nevada - Video
The Southern Nevada Water Authority wants to take billions of gallons of water that doesn’t exist from Eastern Nevada via a pipeline that would cost ratepayers $15 billion. Doing so would devastate the wildlife and people who live there. That’s according to Kyle Roerink, executive director of the Great Basin Water Network, which opposes the pipeline.
Las Vegas Election Night Wrap-Up
The Review-Journal's Politics and Government Editor, Steve Sebelius, wraps up election night. (Mat Luschek / Review-Journal)
Olivia Diaz Speaks To Ward 3 Supporters After Primary Election - Video
Olivia Diaz speaks to her supporters at a election party after results started coming in for the Ward 3 primaries.
Oscar Goodman Speaks On Behalf Of Mayor At Primary Win (edited)
Oscar Goodman spoke Tuesday night on behalf of his wife, Carolyn, who won the mayoral primary election. (Mat Luschek / Review-Journal)
Oscar Goodman Speaks On Behalf Of Mayor At Primary Win (Full)
Oscar Goodman spoke Tuesday night on behalf of his wife Carolyn, who won the mayoral primary election. (Mat Luschek / Review-Journal)
Gun Debate Shows Limits Of Government - Video
On Monday, the Assembly and Senate Judiciary Committees held a joint hearing on Assembly Bill 291. It would ban bump stocks and allow local governments to pass additional restrictions on firearms.
Lucy Flores speaks out about Biden incident
Former Nevada assemblywoman, Lucy Flores, expresses her feelings about an incident with former Vice President Joe Biden in 2014. (Michael Quine/Las Vegas Review-Journal) @Vegas88s
Harry Reid takes the stand in injury lawsuit
Former U.S. Sen. Harry Reid took the stand on Thursday in the product liability lawsuit brought against the makers of a resistance exercise band that Reid blames for blinding him in one eye.
Jurors hear opening statements in Reid personal injury trial
Opening statements were made on Tuesday in the product liability lawsuit brought by Harry Reid against against the makers of a resistance exercise band that Reid blames for blinding him in one eye.
Mayor Goodman delivers Meals on Wheels
Mayor Carolyn Goodman delivers Meals on Wheels to seniors on March 26, 2019.
Las Vegas City Council Ward 1 race
Candidates for Las Vegas City Council Ward 1. (Shea Johnson/Las Vegas Review-Journal)
THE LATEST
Nevada gets $3M in settlement for ITT students

Attorney General Aaron Ford announced his office has reached a settlement with Student CU Connect CUSO, a company that offered loans for students attending ITT Tech that Ford called abusive.