Advocate staff photo by RICHARD ALAN HANNON Bruce Greenstein, secretary of the Department of Health and Hospitals, monitors his phone Monday as he waits his turn in front of the Senate Finance committee. He said further reducing the pay for doctors, clinics, hospitals and other medical care providers for Medicaid patients could jeopardize the availability of care for the state’s poor.
State health chief Bruce Greenstein on Monday outlined cuts his agency would have to make if $100.7 million in one-time money the House stripped isn’t restored.
The $100.7 million equates to $350 million because the state money attracts federal funds, he said.
Budget actions in the Louisiana House has reduced the health agency’s proposed $8.95 billion budget by approximately $500 million since it was proposed by Gov. Bobby Jindal.
An already planned reduction of nearly 4 percent in the amount paid to the state’s physicians, hospitals and other Medicaid health care providers would now become a 9.7 percent reimbursement reduction, Greenstein said. Additionally, pharmacists would get less reimbursement through the Medicaid drug program.
Greenstein said a nearly 10 percent cut could jeopardize the state’s new private insurance-based system for the poor, called Bayou Health. The program must have an adequate network of health care providers to deliver the care, he said. But with a substantial reduction in pay, many physicians, clinics, hospitals and other providers could opt not to participate, he said.
“The question remains will we be able to keep an adequate provider network to achieve actuarial soundness. That remains to be seen,” Greenstein said.
The state Department of Health and Hospitals would also have to close the state mental health hospital at Pineville and eliminate state funding for 65 school-based health clinics. Programs that would be canceled include breast and cervical cancer screening, hospice care, and adult dentures, he said.
Other programs that help babies and young children with developmental disabilities as well as community mental health services, including one that caters to the very young, would be closed, Greenstein said.
“These are not meant to scare anyone or put fear in groups to get mobilized. We are actually giving the best case scenario and the best case scenario is pretty bad,” said Greenstein.
Greenstein said there is no way for his agency to implement the cuts required without impacting “critical services” which the House put off limits when it approved the one-time-money-less House Bill 1. He called the list of cut options provided “pure fallacy… Professional service contracts are not just graphic artists or accountants, they are physicians” and others that the agency use to provide services.
Vacant positions, another option, doesn’t work for DHH because the positions aren’t funded anyway and suggested furloughs don’t work because employees must report to duty who take care of some of the most vulnerable, Greenstein said.
“They all impact critical services,” Greenstein said.
Meanwhile, LSU System Vice President Fred Cerise told the Senate Finance Committee that an earlier round of cuts eliminating $21.5 million in the state funding of LSU hospitals across south Louisiana would lead to more elimination of services and problems with LSU’s medical training programs.
The cuts came in response to a reduction in state revenues after the Jindal administration filed the budget bill.
“This year we are in the middle of some pretty significant cuts so when you talk about making cuts and not effecting critical services, we are past that point,” said Cerise, who oversees health care and medical education programs.
Cerise said people are already more people are leaving emergency rooms at Chabert Medical Center in Houma and University Hospital in New Orleans without being seen. In addition, program cutbacks and reduction in hospital beds are resulting in fewer patients for physicians in training programs that require certain patient volumes, Cerise said. The accreditation agency has already raised questions about the situation in the New Orleans hospital’s emergency room, he said. In addition, only one out of seven spots in the family medicine program at the University Medical Center in Lafayette are filled, he said.
