1. Alaska Medicaid January 27, 2014 Department of Health & Social Services Director Margaret Brodie

2. We aim to: » Integrate and coordinate services » Strategically leverage technology » Implement sound policy » Practice fiscal responsibility » Measure and improve performance 2

3. Incremental Change from FY 2014 to FY 2015 Medicaid Budget 3

4. FY13 Medicaid Direct Services Expenditures by Division (thousands) 4

5. 5 Medicaid ProgramCovered Services Behavioral Health Medicaid Mental health clinics, substance abuse clinics, psychiatric physicians, residential psychiatric treatment centers, and inpatient psychiatric hospitals. Children’s Medicaid ServicesBehavioral rehabilitation services for children. Health Care Medicaid Services Inpatient and outpatient hospital services, physician services, pharmacy, transportation, dental, vision, laboratory and Xray services, physical/occupational/speech therapy, chiropractic, medical equipment, home health, hospice, and state-only Medicaid benefits. Other activities supporting direct services delivery include providing Medicare premium assistance for dual eligibles, recovering third-party liability payments, and making supplemental (disproportional share, or DSH) payments to hospitals. Adult Preventative Dental Medicaid Services Preventive and restorative dental services for adults. Senior and Disabilities Medicaid Services Nursing home and personal care services. Home and community based waiver programs for children with complex medical conditions (CCMC), individuals with intellectual and developmental disabilities (IDD), Alaskans living independently (ALI), and adults with physical and developmental disabilities (APDD).

6. Medicaid 6

7. Primary Service Population 7

8. All Medicaid Direct Services Beneficiaries and Expenditures 8

9. Total Spending on Medicaid Services 2002-2032 9

10. 10 New way of doing things or innovative idea

11. » Super-utilizers » Patient Centered Medical Home » Payment Reform » Prior Authorization » Fraud Control » DJJ Medicaid » Tribal Partnerships » Surveillance Utilization Review (SUR) » Audits 11

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13. Modified Adjusted Gross Income (MAGI) 13

14. Federal Medical Assistance Percentage (FMAP) » Designed so that the federal government pays a larger portion of Medicaid costs in states with lower per capita incomes relative to the national average ◆ Statutory minimum of 50% ◆ Statutory maximum of 83% ◆ FY2014 range: 50% to 73.05% 14

15. How FMAP Rates are Calculated » State FMAP = 1 – ((Per capita income of the state) 2 /(Per capita income of the US) 2 * 0.45 ◆ Average of the 3 most recent calendar years ◆ Data comes from the Department of Commerce 15

16. FMAP Rates 16

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18. Drug Rebates by Fiscal Year » SFY2002 $12,707,783.00 » SFY2003 $17,874,641.00 » SFY2004 $22,292,721.00 » SFY2005 $30,198,724.00 » SFY2006 $31,973,832.00 » SFY2007 $20,587,052.00 » SFY2008 $21,885,791.00 » SFY2009 $24,100,669.00 » SFY2010 $28,979,844.00 » SFY2011 $39,247,247.00 » SFY2012 $46,053,418.00 » SFY2013 $35,554,199.00 18

19. 19 Questions?