- Associated Press - Monday, January 30, 2017

MONTGOMERY, Ala. (AP) - Medicaid Commissioner Stephanie Azar said Monday that the state is at a “crossroads” over whether to continue a proposed switch to managed care.

Since 2013, Alabama has been working on a plan to shift some of the state’s 1 million Medicaid patients to managed care provided by Regional Care Organizations. The state pushed back implementation until Oct. 1 because of uncertainty over funding.

Azar said federal Medicaid officials will withdraw the waiver if the state does not implement the regional care program by October.

“We are at crossroads at the program. We can’t implement it any farther than Oct. 1. and funding, obviously, remains an issue for the program and our Medicaid program in general,” Azar said.

Lawmakers approved the shift to managed care in the hopes that it would slow the growth of Medicaid expenses.

She said the state Medicaid program will need an increase of about $44 million in the budget lawmakers will begin writing in the session that begins next week.

Azar said she did not know what changes the Trump administration will being to Medicaid.

“We don’t know what we don’t know,” she said. However, Azar cautioned that the state needs to play a role in any block grant design to make sure the state doesn’t end off “worse off.”

Lawmakers used oil spill settlement funds to patch together Medicaid’s budget in 2017 and 2018. Azar said the money was a “god send” for the program. However, she said Medicaid faces a “train wreck” in 2019 without new revenue.

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