Minnesota is asking the federal government to waive a number of federal Medicaid rules, which Gov. Mark Dayton says would save the state about $151 million over the next five years.
The federal government pays about half of the costs associated with Medical Assistance, Minnesota's Medicaid program, said state Department of Human Services Commissioner Lucinda Jesson.
"To get those hundreds of millions of federal dollars we have to agree to a lot of federal rules," Jesson said. "We could do a better job here in Minnesota, get better outcomes for people, save both federal and state tax dollars, if we did things differently."
The proposed changes include an emphasis on intervening before Medicaid patients rack up huge medical bills.
"We are providing more community living supports to a broader group of people," Jesson said. "We're trying to reach people before they qualify for extensive Medicaid services and figure out what do we do to keep these people in their jobs, in their homes and their communities."
Minnesota also is proposing to make the state's personal care assistance program more flexible, which the proposal says would take pressure off the system.
The proposed changes would also shift part of the financial burden of treating patients at the Anoka Metro Regional Treatment Center to Medicaid, which would save the state $89 million over the next five years if the federal government allows the change. The federal government currently doesn't pay costs associated with inpatient care at larger mental health centers like Anoka.
"That goes back to when people were in these hospitals for often, sadly, years and years," Jesson said. "Most people at Anoka, they're not there for years... We think the payment structure ought to reflect the new reality of treatment in Anoka."
The federal government will collect public input on the changes for 30 days. It will then negotiate with the state.
Jesson said the first changes, if approved by the federal government, would go into effect in January 2014.
"It's not just going to all go into effect, nothing is going to change overnight. This is really a new direction for our Medicaid program," Jesson said. "And it's a new direction that with the federal government's approval, will go into place in the next several years."
The Minnesota Department of Human Services submitted the waiver request to the federal Centers for Medicare and Medicaid Services on Friday. Dayton wrote in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius that the plan "offers a comprehensive approach for meeting the challenges of rising healthcare costs and an aging population, while still providing Minnesotans the services they need to lead meaningful and fulfilling lives."
Medicaid is a federal program that was created in 1965 and provides health coverage for some low-income people. The program is administered by the states.