division of medicaidchildren’s health insurance program (chip) enrollment 12,757 30,736 49,608...

1

State of MississippiOffice of the Governor

Division of Medicaid

Rica Lewis-PaytonExecutive Director

2

517,693

559,379646,925

709,260 720,304

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

FY1999 FY2000 FY2001 FY2002 FY2003

Total Medicaid Certified Eligibles

3*Does not include CHIP

287,969

12,918

321,161

13,528

386,681

14,236

426,607

15,144

422,863

15,131

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

450,000

500,000

FY1999 FY2000 FY2001 FY2002 FY2003

Eligibles 21 Years and Under

Aged 18 and Under Aged19 to 21

Total300,887

Total334,689

Total400,917

Total441,751

Total437,994

4

Children’s Health Insurance Program (CHIP) Enrollment

12,757

30,736

49,608 52,510

58,601

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

FY1999 FY2000 FY2001 FY2002 FY2003

5

Cost Saving InitiativesDecreased AWP to - 12%.

Rx limit to 34 day supply.

Dispensing fee reduced to $3.91.

Mandated equivalent generic drugs.

Dually eligibles’ claims submitted to Medicare first.

Reduced reimbursement rate by 5%.

Hosp. bed assessment - $1.50/day.

LTC assessment increased to $4.00/day.

Established a P&T Committee.

One pair of eyeglasses every 5 years.

Eliminated HealthMACS.

Disease Management Program.

Five prescriptions per month with an additional 2 available w/PA.

Expanded Rx PA.

Eliminated transportation payments to family and attendants.

Limited svcs to pregnant women.

ER redirection.

Max. co-pay schedule.

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Disease Management Program(As of August 31, 2003) Enrollees

Asthma 21,732Diabetes 8,651Hypertension 4,282

DM Active Total 34,665

NurseLine 22,222

Projected Annual Savings - $8.4 million

Home Delivered Medications(As of August 31, 2003)

Beneficiaries 641

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Medicaid FY 2003 Funding Sources

1%

78%

8%

4%

2%4%

3%Federal FundsGeneral FundsInter-Gov. TransfersAssessmentsFunds from Other State AgenciesH.C.E.T. FundBudget Cont. Funds

Federal Funds $2,402,410,205

General Funds 236,953,687Inter-Gov. Transfers 135,219,135Assessments 55,388,743Funds From Other Agencies 108,422,459H.C.E.T. Funds 131,818,607Budget Cont. Funds 43,017,795

Sub Total of State Match $ 710,820,426

TOTAL $3,113,230,631

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76.78% 76.80% 76.82% 76.09% 76.62%

77.09%

2.95%

70.00%

72.00%

74.00%

76.00%

78.00%

80.00%

82.00%

FFY1999 FFY2000 FFY2001 FFY2002 FFY2003 FFY2004

Federal Medical Assistance Participation (FMAP) Rate

Base FM AP Enhanced Payment

Total-80.04%

*

* There was a 2.95% enhancement for April – June, FY2003

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$ 1, 8 9 4 , 0 7 4 , 2 3 9

$204,370,198

$ 2 , 14 9 , 4 9 2 , 5 9 2

$195,269,945

$ 2 , 3 8 5 , 2 6 6 , 5 9 8

$220,674,950

$ 2 , 8 0 0 , 7 4 8 , 7 0 8

$237,590,952

$ 3 , 113 , 2 3 0 , 6 3 2

$236,953,687

$0

$500,000,000

$1,000,000,000

$1,500,000,000

$2,000,000,000

$2,500,000,000

$3,000,000,000

$3,500,000,000

FY1999 FY2000 FY2001 FY2002 FY2003

Total Medicaid Annual Expenditures w ith Total General Fund Annual Expenditures

TOTAL GENERAL FUND

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Expenditures for Medical Services - FY2003

Drugs21%

EPSDT2%

Physician Services8%

Nursing Facility17%

Out-Patient Hospital7%

IP Hospital16%Balance of Svcs.

29%

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$259,761,022

$339,685,539

$465,318,052

$567,739,563 $552,301,913

0

100,000,000

200,000,000

300,000,000

400,000,000

500,000,000

600,000,000

FY1999 FY2000 FY2001 FY2002 FY2003

Pharmacy - Total Expenditures

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15.75%

30.77%

36.32%

21.99%

-2.86%

-5.00%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

FY1999 FY2000 FY2001 FY2002 FY2003

Pharmacy Expenditure Changes from Previous Fiscal Year

13

$333,733,346 $355,601,306$379,170,873 $404,010,377

$432,532,351

0

50,000,000

100,000,000

150,000,000

200,000,000

250,000,000

300,000,000

350,000,000

400,000,000

450,000,000

500,000,000

FY1999 FY2000 FY2001 FY2002 FY2003

Nursing Facility Expenditures

14

$295,121,216 $301,869,287

$353,715,319

$383,234,003 $407,609,891

$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000

$300,000,000

$350,000,000

$400,000,000

$450,000,000

FY1999 FY2000 FY2001 FY2002 FY2003

In-Patient Hospital Expenditures

15

$106,411,252

$132,250,593

$166,098,569

$197,361,117$207,033,240

0

50,000,000

100,000,000

150,000,000

200,000,000

250,000,000

FY1999 FY2000 FY2001 FY2002 FY2003

Physician Expenditures

16

$ 75, 130, 125$ 88, 032, 588

$ 106, 749, 858

$ 146, 232, 742

$ 178, 652, 921

0

20,000,000

40,000,000

60,000,000

80,000,000

100,000,000

120,000,000

140,000,000

160,000,000

180,000,000

200,000,000

FY1999 FY2000 FY2001 FY2002 FY2003

Outpatient Hospital Expenditures

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FY 2003 Administrative Expenditures Compared to Appropriation

EXPENDITURE FY 2003 FY 2003 DifferenceCATEGORY Appropriation Expenditures O ver (Under)

SALARIES $27,212,227 $21,897,712 $5,314,515TRAVEL 722,610 439,992 282,618CONTRACTUAL 81,578,007 72,943,566 8,634,441COMMODITIES 844,734 817,312 27,422CAP. OUTLAY OTH EQUIPMENT 944,955 781,611 163,344$

TOTAL $111,302,533 $96,880,193 ($14,422,340)

The unspent administrative funds were shifted to S,L,&G to purchase additional medical services for Medicaid recipients.

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Division of Medicaid FY 2005Budget Request

Funding Categories

Actual FY 2003

FY 2004 Appropriation

FY 2005 DOM Request

GENERAL FUNDS $236,953,687 $246,855,284 $337,082,546H.C.E. FUNDS 131,818,607 57,752,630 57,752,630BUDGET CONT. FUNDS 43,017,795SHORTFALL * 13,200,000 90,227,262

TOTAL FUNDS $424,990,089 $394,835,176 $394,835,176

* - FY03 and FY04 shortfall covered by the additional FMAP.