| Changes from FY 2008-09 Year-to-Date: |
|
| 1. Medicaid Base Funding. The Governor included base adjustments for Medicaid, Community Mental Health (CMH) Medicaid services, the Children's Special Health Care Services program, and the Adult Benefits Waiver. These adjustments would increase GF/GP costs by $131,236,000. |
366,770,400
|
| 2. Actuarially Sound Rates. The Governor provided an adjustment in Medicaid managed care capitation rates of 4.5% and CMH Medicaid rates of 4.0% to meet Federal requirements that capitation rates be actuarially sound, at a cost of $72,777,500 GF/GP. |
197,711,000
|
| 3. Replacement of Managed Care Quality Assurance Assessment Programs (QAAPs) with Use Tax. Effective April 1, 2009, the Medicaid managed care QAAPs will be repealed. Medicaid managed care organizations and CMH Medicaid services will become subject to the Use Tax. This change is, in effect, a fund source shift from Restricted revenue to GF/GP and will increase GF/GP expenditures by $304,704,300. |
28,569,600
|
| 4. Special Medicaid Payments and Quality Assurance Assessment Program (QAAP) Adjustments. The Governor's budget reflected the anticipated Federal revenue available for various special financing mechanisms and made adjustments to maximize use of QAAP revenue, including a payment to hospitals through the CMH Medicaid program. |
116,526,000
|
| 5. Fund Source Adjustments. The Governor included adjustments reflecting the loss of revenue from the Medicaid Benefits Trust Fund and the Merit Award Trust Fund, resulting in a GF/GP cost increase of $61,264,400. |
0
|
| 6. Medicaid Match Rate Adjustments. The Governor assumed savings of $246,526,000 GF/GP from the increase in the base Medicaid match rate from 60.27% to 63.19%. The Governor assumed further savings of $483,963,500 GF/GP from an increase in the match rate to 68.415% due to the Federal Stimulus bill. |
0
|
| 7. Long Term Care Program Expansions. The Governor included $15.3 million for expansion of community based care and assumed $33.5 million in savings from reduced utilization of nursing homes. |
(18,217,500)
|
| 8. Federal Funds. The budget reflected anticipated changes in Federal grants and the removal of $100.0 million in placeholder funds for the Michigan First Healthcare Program. |
(63,878,400)
|
| 9. Cost Reduction Measures. The Governor's budget reflected the closure of the Mount Pleasant developmentally disabled facility ($20.4 million), assumed passage of legislation placing mental health medications on the preferred drug list ($18.7 million), and assuming passage of Federal legislation permitting the State to collect pharmaceutical rebates on drugs prescribed for Medicaid managed care clients ($120.0 million). The budget also included numerous program cuts, including reductions to CMH non-Medicaid services, substance abuse, multicultural, respite care, rural health, family planning, the Nurse Family Partnership, and $2.0 million in cuts to the Healthy Michigan Fund, saving a total of $74.3 million GF/GP. |
(184,894,900)
|
| 10. Economic Adjustments. These adjustments cost $5.9 million GF/GP. |
13,464,800
|
| Total Changes |
$457,903,500
|
| FY 2009-10 Governor's Recommendation |
$12,966,966,900 |