SPB 7174 - Medicaid Summary

• Renames the "medically needy" program to "Medicaid nonpoverty medical subsidy" and limits eligibility for families, seniors, and disabled persons to physician services only beginning April 1, 2012.

• Eliminates the hospitalist program for managing Medicaid hospital admissions and extends the neonatal intensive care utilization management program.

• Revises pharmaceutical reimbursement formulas by reducing the wholesaler acquisition cost (WAC) markup from 4.75 percent to 1.5 percent to lower ingredient costs.

• Adjusts the nursing home facility quality assessment to allow up to the maximum percentage permitted under federal law instead of the fixed 5.5 percent cap.

• Extends the prohibition on distributing funds under the regional perinatal intensive care centers and primary care disproportionate share programs for fiscal year 2011-2012.