division of medicaidchildren’s health insurance program (chip) enrollment 12,757 30,736 49,608...
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State of MississippiOffice of the Governor
Division of Medicaid
Rica Lewis-PaytonExecutive Director
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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
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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
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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
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$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
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$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
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$106,411,252
$132,250,593
$166,098,569
$197,361,117$207,033,240
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
FY1999 FY2000 FY2001 FY2002 FY2003
Physician Expenditures
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$ 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.