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Parts of Arizona Medicaid plan rejected

Arizona can’t deny health coverage to about 60,000 low-income parents, federal health officials said Oct. 7.

The state had asked the Centers for Medicare and Medicaid Services to allow the elimination of health coverage of parents whose family income falls between 75 and 100 percent of the poverty level.

The changes to the state Medicaid plan were part of a cost-cutting move to help close a severe budget shortfall.

Health officials denied a few other requests and approved some others, as well.

“You’re never going to get everything that you asked for,” said Matthew Benson, the governor’s spokesman.

Benson said the governor is still pleased that federal health officials didn’t object to the “lion’s share” of her state health plan submitted earlier this year.

Benson is referring to the freeze on the childless adult population that is now in effect and to several other major changes to the Arizona Health Care Cost Containment System.

Those changes would allow the state to save hundreds of millions of dollars.

The requests that were rejected Oct. 7 would have saved the state about $50 million, Benson said.

“It’s not an insignificant number, but in the context of about a $500-million package of reforms, it certainly is not an overwhelming amount,” he said.

In a telephone briefing, a federal health officer said her agency will approve Arizona’s plan to impose copayments on certain patients and to deny health coverage to others.

Arizona, for example, may impose a $4 co-payment for non-emergency transportation in two counties, with some exemptions.

Some patients who miss medical appointments may also be charged with a $3 fee.

And the state doesn’t have to provide screening benefits and treatment to 19 and 20 year olds under the childless adult group.

Arizona is applying for a new Medicaid waiver, which would allow the state some flexibility in operating its state health program. Arizona’s “old” waiver ends this month.

The state and the federal health department have been in talks over the waiver request.

But a health official said the state hasn’t provided sufficient justification to roll back coverage for low-income parents.

Waivers are meant to further the goals of the Medicaid program, and cost-savings alone are not sufficient reason to serve those objectives, said Centers for Medicare and Medicaid Services Director Cindy Mann.

“Cutting off people who are otherwise legally in the program — the cost-savings from that is not a sufficient justification for exercising the (U.S. health) secretary’s authority” to grant a waiver, Mann said in a telephone conference.

Other changes federal officials denied include a proposal to charge $50 annually to childless adult patients who smoke.

Some items are still outstanding, including Arizona’s request to be able to create an uncompensated care pool and a reimbursement rate cut to health providers.

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