Report Highlights Medicaid News In Three States

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Summaries of recent news about the Medicaid programs in Georgia, Illinois and North Carolina appear below.


Administrative and other barriers prevent thousands of eligible children from receiving Medicaid and PeachCare coverage, according to health advocates and pediatricians, the Atlanta Journal-Constitution reports. PeachCare is the state's version of SCHIP. Although the state's population has steadily increased over the past two-and-a-half years, the number of children covered by the two public insurance programs has fallen by more than 100,000, according to the Journal-Constitution.

In 2006, Georgia began requiring that families show proof of citizenship and identification when signing up for Medicaid and PeachCare to prevent undocumented immigrants from enrolling in the programs. The state also began requiring that applicants provide pay stubs, W2s or letters from employers to verify their income. The state's eligibility rules are "among the most restrictive" in the nation, according to Donna Cohen Ross of the Center on Budget and Policy Priorities. Aside from these changes, experts say the application process is "cumbersome," according to the Journal-Constitution.

State Medicaid officials say they are simplifying application forms, and PeachCare this year began reaching out to parents when the school year started, which it did not do for the past two years (Miller, Atlanta Journal-Constitution, 10/12).



Illinois' Medicaid program now will cover a genetic test that indicates whether a woman is at increased risk for breast cancer and will offer counseling to those testing positive, the Chicago Tribune reports. BRCA1 and BRCA2 gene tests can identify mutations on the BRCA genes, which have been linked to cancer. As many as 70% of the women who have this genetic mutation will be diagnosed with breast or ovarian cancer by age 70. Any doctor participating in the state program can administer the test, and beneficiaries found to have the genetic indicator can receive counseling from licensed genetic counselors if they work with physicians (Graham, Chicago Tribune, 10/14).

North Carolina

North Carolina Medicaid beneficiaries who were seen by the same primary-care physician for more than five years were twice as likely to receive screenings for certain types of cancer than those who saw the same physician for less than two years, according to a study published this week in the Archives of Internal Medicine, the Winston-Salem Journal reports. The study involved nearly 2,000 Medicaid beneficiaries ages 50 and older in 2004 and found that about half received screenings for colorectal, breast and cervical cancers -- conditions that are highly treatable if detected early.

Lead study author Annette DuBard of the North Carolina Medicaid's Quality Evaluation and Health Outcomes unit said a long-term history helps a physician "to build a rapport with the patient and to appropriately address cancer screening options." She said, "Too often, discussions about preventive-health measures get edged out by the more immediate health concern that led to the visit to the doctor." William Lawrence, another author of the study and a former director of the state's Medicaid program, said that the percentage of Medicaid beneficiaries who receive screenings should increase as more people become aware of programs like ACCESS/Community Care of North Carolina, which encourages Medicaid beneficiaries to make regular visits to a physician to receive early diagnosis and treatment for potential health conditions (Craver, Winston-Salem Journal, 10/14).

Community Care assigns beneficiaries to case managers who help them "navigate the health care system," according to the Raleigh News & Observer. An independent analysis shows that the state saved $2 for every dollar spent on the program, which treats more than 810,000 Medicaid beneficiaries in 14 not-for-profit networks throughout the state. The program, developed in the late 1990s, saves the state about $100 million annually, the News & Observer reports (Goldsmith, Raleigh News & Observer, 10/12). According to the North Carolina Department of Health and Human Services, millions of health care dollars can be saved annually by preventing easily treatable conditions from worsening and avoiding costly emergency department visits (Winston-Salem Journal, 10/14).

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