- Associated Press - Friday, April 8, 2016

SANTA FE, N.M. (AP) - Health care workers are raising concerns about closed-door meetings as New Mexico forges a plan to rein in spending on Medicaid by some $400 million under a new state budget.

An advisory group delivered its first recommendations Friday on reducing Medicaid reimbursement rates for medical services to health care providers, though the advice was not made public.

The Human Service Department that oversees the state Medicaid program is collecting suggestions from industry stakeholders on how to slow spending without undermining care and facilities for the poor and disabled.

Here’s a look at recent and new developments:

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WHY IS NEW MEXICO TRYING TO TRIM PROJECTED MEDICAID SPENDING?

The Legislature and Gov. Susana Martinez underfunded Medicaid by $86 million between now and mid-2017 in the new state budget. That means New Mexico may forgo well over $300 million in federal matching funds.

At the same time, New Mexico residents have flocked to Medicaid since eligibility was broadened in 2014 and more people became aware of the program. Full Medicaid coverage now extends to more than one-third of New Mexico’s 2.1 million residents, with many more receiving partial coverage.

The New Mexico Human Services Department is gathering suggestions on how to contain costs from a Medicaid Advisory Committee of stakeholders from medical associations, the Navajo Nation, advocates for the disabled, a Christian ministry, the state university hospital system, health care giant Presbyterian Medical Services.

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ARE ADVISORY GROUP MEETINGS CLOSED TO THE PUBLIC, AND WHY?

Notes from an advisory subcommittee meeting in March show members decided that “meetings open to the general public might be counterproductive” because of short time constraints. Only members and select experts can attend.

Hospital nurse and technician union leader Lorie MacIver says she and another labor representative were turned away from one of those meetings Tuesday. They have sent a letter of protest to Human Services Secretary Brent Earnest that says consumers and health workers are being unfairly excluded as policy decisions are forged in secret.

Human Services spokesman Kyler Nerison says it’s important to note that the Medicaid advisory groups cannot make policy decisions and thus don’t have to hold open meetings. The agency says policy recommendations submitted Friday will be made public in the coming week.

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WHAT MEDICAID SERVICES MIGHT BE AFFECTED AS SPENDING IS TRIMMED?

Reimbursement rates are likely to be reduced for individual medical services. That holds implications for hospitals, private medical practices and specialists and clinics in between.

The Legislature also is suggesting a roll-back of rate increases to primary care physicians. The state may rethink its supplemental payments to hospital that provide care without compensation to the uninsured.

Jeff Dye, president of the New Mexico Hospital Association, warns that rate changes can have a major impact on whether hospitals can maintain services such as obstetrics and outpatient dental care.

Medicaid patients may eventually have to share more costs, possibly through co-pays and monthly service premiums - though federal permission would be needed first.

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COULD THE STATE STILL RAISE MORE MONEY FOR MEDICAID THIS YEAR?

The governor is holding fast to pledges against raising taxes under the power of her veto pen, while winding down corporate income taxes.

A variety of advocacy and health care industry groups still want the state to consider raising revenues. Abuko Estrada of the New Mexico Center on Law and Poverty calls the looming cutback on Medicaid spending a deliberate policy choice that can be reversed.

Lawmakers, including Rep. Larry Larranaga, the Republican chairman of the House Appropriations Committee, say the state has to start devising savings as New Mexico inherits a larger share of Medicaid costs from the federal government.

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This story has been corrected to show the name of the New Mexico Hospital Association’s president is Jeff Dye, not Jim Dye.

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