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Changes to Md. Medicare waiver in works

Published on NewsOK Modified: January 22, 2013 at 7:04 pm •  Published: January 22, 2013

ANNAPOLIS, Md. (AP) — Maryland officials will submit a plan to the federal government aimed at allowing them to hang onto about $1 billion in Medicare reimbursements received under a unique agreement with Washington, the chairman of a panel that sets hospital billing rates told lawmakers Tuesday.

John Colmers, chairman of the state's Health Services Cost Review Commission, updated lawmakers on the status of talks with the federal Center for Medicare and Medicaid Services on the state's Medicare waiver.

"I will say that we have been very greatly encouraged by those discussions with CMS," Colmers told the Senate Budget and Taxation Committee. "They are excited, I would say, about the opportunity to see a state as a whole take on this challenge of reducing health care costs and improving care. Now, there are a lot of difficult steps between where we are now and getting it completed."

Maryland is the only state in the nation to have the Medicaid waiver agreement, which has been in place since 1977. It allows Medicare and Medicaid payments to be based on rates set by the state commission, instead of national federal payment principals.

However, Maryland must meet tests showing that cumulative growth in state payments doesn't exceed the rate of growth in Medicare payments nationally.

The state aims to keep a cushion of how much Medicare payments could grow before exceeding the national limit. Maryland has tried to maintain a 10 percent minimum, but it is projected to fall under 2 percent.

As the state gets closer to failing to meet the standard, officials are searching for ways to make changes to keep the waiver.

"The bottom line is that, again, these discussions with Medicare around the waiver test are largely around how is it that we can redesign our delivery system to result in better care, a lower cost and better health, and the waiver test is a way of achieving that," Colmers said.

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