medicaid task force presentation april 24, 2013
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Medicaid Task Force Presentation April 24, 2013. County Medical Relief. Qualifying Circumstances for County Medical Poor Relief. Social Security Disability- insurance gap. Increased health problems with decreased income. Illness or injury. Pre-existing condition/ uninsurable. - PowerPoint PPT PresentationTRANSCRIPT
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Medicaid Task ForcePresentation
April 24, 2013
County Medical Relief
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• Social Security Disability- insurance gap
• Increased health problems with decreased income
• Illness or injury
• Pre-existing condition/ uninsurable
• Health insurance unaffordable
Qualifying Circumstances for County Medical Poor Relief
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Hospital Notice SDCL 28-13-34.1
Application for Poor ReliefSDCL 28-13-32.3 & 32.4
Residency Requirement SDCL 28-13-3 & 28-14-2.1
Post- Secondary Student SDCL 28-13-27(6)(b)
Veteran or Indian Health Services SDCL 28-13-1.3(5)
Emergency vs. non-emergency admissions SDCL 28-13-33
Ability to purchase Health Insurance SDCL 28-13-27(c)(d)
Hospital must exhaust all avenues of paymentSDCL 28-13-33.2
ELIGIBILITY CHECKLIST
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Household resources
(SDCL 28-12-32.8)
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Household Income
(SDCL 28-13-32.7)
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Determining person’s ability to pay (SDCL 28-13-32.9)
Household Factors
• contributions • expenses• discretionary income
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Ability to purchase health insurance
(SDCL 28-13-32.11)
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Cost saving Resources to Counties• Federal Risk Pool
• South Dakota Risk Pool
• COBRA Premiums
• Community Health Clinics (CHC)
• Prescription Assistance Programs
• Veteran Health• Indian Health Services• Medicaid Programs
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Statewide County Medical Expenses
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Counties not reported
2010 Douglas, Faulk, Yankton
2011 Yankton
2012 Charles Mix, Douglas, Mellette, Yankton
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County Medical Indigent Expense
2010 $3,142,646.00
2011 $3,153,617.69
2012 $2,543,429.05
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County Jail Medical Expense
2010 $2,470,838.05
2011 $2,488,687.29
2012 $2,786,048.93
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Involuntary Alcohol and Mental Health
2010 $1,861,917.61
2011 $1,966,633.91
2012 $2,543,429.05
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Payments or reimbursement to countiesNote: includes payments for non-medical items
Client Payments
Third Party Reimbursement Total
2010 $830,475.49 $213,084.47 $1,043,559.962011 $1,117,148.13 $280,384.28 $1,397,532.412012 $920,516.56 $208,702.53 $1,129,219.09
Catastrophic Medical Pool
Reimbursements County Contributions$313,006.46 $327,568.00$418,895.95 $306,371.00$171,407.06 $395,459.00
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2010 Medical Expenses Health InsuranceCounty Total County Total County Health Insurance
Total $3,142,646.00 Total $106,134.08MINNEHAHA $1,020,529.00 BON HOMME $13,011.42 MINNEHAHA $65,754.00BROWN $437,165.77 LAKE $10,994.52 PENNINGTON $19,346.07PENNINGTON $223,718.82 LAWRENCE $9,159.02 BROWN $12,123.25DAVISON $219,959.32 MC PHERSON $8,628.40 GRANT $3,579.75LINCOLN $209,317.93 CLAY $7,980.31 DAVISON $3,265.09BROOKINGS $102,477.50 CLARK $7,422.33 CODINGTON $1,094.68MOODY $92,314.09 STANLEY $7,398.31 BEADLE $708.26DAY $85,025.56 HYDE $7,000.00 MC COOK $262.98HUTCHINSON $66,736.74 CHARLES MIX $6,313.67BEADLE $62,738.93 ROBERTS $4,573.60MC COOK $52,607.68 UNION $4,500.00TRIPP $47,450.07 AURORA $3,368.88HUGHES $42,952.15 HANSON $2,452.48TURNER $35,392.86 DEWEY $1,517.00SPINK $33,426.32 FALL RIVER $1,425.43KINGSBURY $32,684.07 HAND $1,366.36POTTER $32,244.54 BUTTE $1,245.21CODINGTON $29,405.48 CUSTER $817.03MARSHALL $27,731.92 JONES $600.00DEUEL $26,838.24 MEADE $270.91MINER $26,319.51JERAULD $25,999.30SANBORN $25,692.71GRANT $19,653.63EDMUNDS $19,375.78BRULE $15,987.64GREGORY $15,436.62SULLY $13,418.94
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2011 Medical Expenses Health Insurance
County Total County Total County Total
Total $3,153,617.69 GREGORY $11,236.26 Total $152,516.21MINNEHAHA $781,276.00 LAWRENCE $10,738.92 MINNEHAHA $83,708.00BROWN $427,095.45 DEUEL $8,273.56 PENNINGTON $22,797.51DAVISON $356,024.45 FALL RIVER $5,159.09 BROWN $14,008.47MARSHALL $251,802.30 STANLEY $5,000.00 CODINGTON $8,072.41PENNINGTON $215,086.66 AURORA $2,287.16 MC COOK $7,423.84LINCOLN $128,373.55 LAKE $2,250.87 GRANT $7,284.65MOODY $105,318.06 TRIPP $2,049.00 LINCOLN $3,374.45BROOKINGS $99,034.97 WALWORTH $1,419.00 DEUEL $3,349.05BEADLE $85,546.55 ROBERTS $639.96 DAVISON $2,153.70POTTER $71,841.96 TODD $608.00 SPINK $344.13KINGSBURY $58,229.97 SULLY $471.33HUTCHINSON $55,406.17 BUTTE $384.73CHARLES MIX $49,608.21 UNION $62.50MINER $43,662.72 EDMUNDS $13.00CLARK $37,563.91MC COOK $33,566.51BRULE $33,242.43HUGHES $33,197.64SPINK $28,889.81DAY $27,384.41HANSON $26,037.27JERAULD $26,010.38CLAY $23,429.11CODINGTON $20,692.69TURNER $19,584.17MEADE $18,516.06MC PHERSON $17,725.19GRANT $17,594.70LYMAN $11,283.01
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2012 Medical Expenses Health InsuranceCounty Total County
Total $2,543,429.05 Total $130,483.31MINNEHAHA $576,683.00 MINNEHAHA $63,114.00BROWN $460,016.82 PENNINGTON $21,964.77PENNINGTON $264,336.33 CODINGTON $10,865.91DAVISON $194,714.58 MC COOK $8,004.00BEADLE $137,512.79 LAKE $7,720.41BROOKINGS $123,028.38 BROWN $6,338.94EDMUNDS $77,369.22 DAVISON $3,906.00LINCOLN $64,560.97 LAWRENCE $2,667.00HUGHES $56,126.86 GRANT $1,841.40KINGSBURY $43,701.97 DEUEL $1,206.83GRANT $41,545.26 BEADLE $1,076.06CLARK $37,730.92 LINCOLN $901.02SPINK $34,907.40 SANBORN $567.89TURNER $33,814.00 SPINK $309.08LAKE $29,221.19HUTCHINSON $29,210.86HAAKON $28,956.94MINER $27,981.38MC COOK $26,516.69ROBERTS $25,940.27MC PHERSON $20,895.50GREGORY $20,312.60JERAULD $20,291.90DEUEL $17,460.54HAMLIN $17,302.00HANSON $15,039.79CODINGTON $14,131.83HARDING $13,122.23UNION $10,914.94WALWORTH $8,532.00
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Sarah PetersenCodington County Welfare Director
President SDACWO
605-882-6286 e-mail