Lawmakers' OK needed to delay health-care payments

Madison — Gov. Jim Doyle's administration lacks the legal authority to use a $127 million accounting trick to help cover a shortfall in state health programs for the poor, the Legislature's nonpartisan budget and audit offices report.
The finding means the Democratic administration could have to seek lawmakers' approval for the budget maneuver, which involves pushing off Medicaid payments to health care providers into the next budget to help cover a hole in the current one. That could pose problems, because the Legislature, now controlled by Democrats, isn't scheduled to return until January, when Doyle leaves office.
Rep. Robin Vos (R-Caledonia), a member of nfl jerseys the Joint Finance Committee, said state officials were potentially costing taxpayers money with the move and should seek lawmakers' approval before proceeding.
"By not making hard decisions now, they're making a bad situation worse," Vos said. "I'd like to have a discussion of whether that's wise."
Even if the provider payments can be delayed, the state still must come up with an estimated $58 million in new state money - or make even larger cuts - to balance the Medicaid budget, according to a new memo released this week by the Legislative Fiscal Bureau.
This latest deficit figure was actually good news for the state's struggling health programs, such as BadgerCare Plus for the poor. The report says a federal law to help states passed earlier this month will provide a projected $194 million in new federal money, a little more than previously announced, to help cover most of the $252 million shortfall in state money currently projected for the health programs.
But that deficit would be even larger if the state weren't in the process of making cuts amounting to $630 million in state and federal money to the program that were called for in the budget passed by lawmakers and Doyle in June 2009.
As part of its plan to do that, the state Department of nfl wholesale jerseys Health Services is proposing delaying $127 million in payments to health vendors such as HMOs that are supposed to be made in May or June 2011, during the current two-year budget. Instead, the state would push those costs into the future and pay the providers in the next two-year budget, starting in July 2011. But if the state doesn't delay the payments, it could have to find new money or cuts to keep those costs from being added to the health programs' shortfall.
Delaying payments has been a frequent tactic to help balance past budgets approved by Legislatures and governors. But if lawmakers don't approve this latest delay of payments, the Legislative Audit Bureau believes it would run counter to state law, according to the new report.
Health Services spokeswoman Stephanie Smiley said her agency is reviewing the Audit Bureau's finding. She cautioned that the department is also still evaluating how much the shortfall for the health programs might be and how much it will need to cut to keep the Medicaid budget in balance.
"If we find that we must still proceed with this cost savings strategy, we will be sure to comply with any necessary legal requirements, including seeking legislative approval if necessary," Smiley said.
Maneuver used before
Smiley noted that then-Gov. Scott McCallum, a Republican, and the Legislature used a similar accounting move with the state's health programs to balance the 2001-'03 budget in the face of a recession.
Doyle and lawmakers have also used delays in payments meant to hold down property taxes and support schools to help balance recent budgets.
The Department of Health Services reported to the Joint Finance Committee on its plans to make the proposed cuts, but the committee hasn't voted on them, Vos said.
Vos said delaying the payments would simply add to the $2.7 billion deficit already expected for the 2011-'13 state budget.
It could also cost taxpayers money, he said. Under the federal law passed this month, the U.S. government is shouldering an extra share of the state's costs for Medicaid health spending through June 2011, meaning that the state would get additional help if it paid the health care providers on time instead of nfl jersey sales waiting until July, Vos said.
The Fiscal Bureau report said that new numbers on the condition of the Medicaid budget are expected in mid-September.