AUGUSTA, Maine — Maine’s Department of Health and Human Services will wait until the Legislature greenlights its budget before taking a federal official up on her offer to help Maine reform its Medicaid program, DHHS Commissioner Mary Mayhew said Wednesday.
Last week, U.S. Health and Human Services Commissioner Kathleen Sebelius said she would send a team of experts to Maine to help the state reduce its Medicaid costs. Sebelius was answering question from U.S. Sen. Olympia Snowe at a meeting of the Senate Finance Committee about how states can save money while preserving Medicaid coverage for residents.
“I actually spoke today with our regional administrator for Medicaid and we talked about engaging their technical assistance team and that we would do so as soon as the Legislature acts on the budget and we know what will be a part of our proposal,” Mayhew said.
Her department can’t begin to work with the team until then, she said.
“Otherwise it’s all hypothetical,” Mayhew said.
The DHHS supplemental budget, covering about $120 million in savings for this fiscal year, is expected to go to a final vote this week. Senate Democrats blocked the measure last Thursday.
Another $80 million in savings for the next fiscal year will be addressed in a separate bill later this month.
LePage has proposed dropping Medicaid benefits, known in the state as MaineCare, for 65,000 Mainers to balance the books at DHHS. About $37 million of those cuts requires Sebelius to grant Maine a special exemption from federal rules that require states to preserve Medicaid coverage.
Democrats have been skeptical that Maine will win the waiver, citing a letter sent last month by the Centers for Medicare and Medicaid Services, which the U.S. Department of Health and Human Services oversees.
The letter said the centers would grant waivers only to states experimenting with new ways to provide coverage to the need, and not to efforts aimed at balancing budgets.
The letter also said legislative action has no bearing on whether the agency would grant the waiver.
Mayhew reiterated Wednesday that Sebelius has told Gov. Paul LePage personally that she can’t respond to a waiver request until the state submits a formal proposal. The federal Medicaid team will work with DHHS to craft its application for a waiver after a budget passes, Mayhew said.
Medicaid’s technical assistance teams partner with states to improve care and track down savings. That can involve restructuring payment systems, identifying programs that could qualify for federal reimbursement and sharing ideas that worked in other states.
Sebelius sent a letter to U.S. governors in February 2011 offering the teams’ tailored assistance to revamp state Medicaid programs. Since then, 25 states, not including Maine, have taken advantage of that help, according to a Centers for Medicare and Medicaid Services spokesman.
DHHS already communicates regularly with the centers, Mayhew said. In recent months, her department has spoken with Medicare officials about efforts to better coordinate care and improve recipients’ health, she said.
“We work very closely with CMS on almost a daily basis, with requests for guidance and clarification around CMS policy,” Mayhew said.