The following summarizes news coverage of recent state Medicaid developments.

• Arkansas: The Pulaski County, Ark., Circuit Court on Tuesday ordered the state Department of Health and Human Services to simplify the Medicaid reimbursement process for assisted-living facilities, the Arkansas Democrat-Gazette reports. Under the new system, facilities will be given a flat rate for each day of care they provide to residents. The current system requires facilities to report minute-by-minute accounts of care for patients. The department will consult with facilities to determine a methodology for calculating reimbursements before setting a date for the process change, spokesperson Julie Munsell said (Baskin, Arkansas Democrat-Gazette, 8/31).
  
  
• Colorado: The joint legislative Health and Human Services Committee on Wednesday voted 15-5 to reject a plan that would have made several changes to the state's Medicaid program for children, including transferring children into managed care plans and assigning them to primary care physicians, the Denver Rocky Mountain News reports. The plan would have transferred about 276,000 children from Medicaid into Child Health Plan Plus, the state's managed care SCHIP program. The changes were expected to reduce Medicaid spending by $6 million annually. The committee rejected the plan after concern was raised about the proposal's planned cap on SCHIP premiums and about a planned increase in provider payments (Scanlon, Denver Rocky Mountain News, 9/1).
  
  
• Florida: The state Agency for Health Care Administration on Wednesday posted on its Web site an application for federal permission to implement a pilot project program that would enroll Medicaid beneficiaries in a managed care system similar to an HMO, the St. Petersburg Times reports. The action was required by the state Legislature, and the application will remain on the Web site for 30 days. Gov. Jeb Bush (R) hopes the pilot program will control Medicaid spending. The pilot project would take place in Duval and Broward counties (St. Petersburg Times, 8/31).
  
  
• Georgia: Indiana-based Eli Lilly on Friday acknowledged that it has offered to fund the creation of Gov. Sonny Perdue's (R) proposals to reduce Medicaid spending, the Atlanta Journal-Constitution reports. Lilly officials said they were in discussions with Georgia officials about a "patient-focused initiative," and Perdue spokesperson Shane Hix said a funding amount has not yet been determined. Consumer advocates criticized the arrangement, saying pharmaceutical companies could use donations or other voluntary programs to influence lawmakers (Miller, Atlanta Journal-Constitution, 8/27).
  
  
• Iowa: The state Medicaid program could have a $5 million surplus this year based on new estimates, state House Speaker Chris Rants (R) said on Monday, the AP/Omaha World-Herald reports. According to Rants, the estimated surplus resulted from a larger-than-necessary appropriations measure and higher-than-expected prescription drug rebates. Rants said that the state should use the surplus to repay the Senior Living Trust, a fund that helps Iowa seniors live independently, because the state Legislature borrowed funds from the trust to finance the state budget and because both programs benefit seniors. He said, "Nobody expected a Medicaid surplus," adding, "This is an opportunity for the state to repay a portion of the money we borrowed from the Senior Living Trust Fund. It was what seniors expect us to do." Gov. Tom Vilsack (D) said that he does not oppose the proposal to repay the fund but questioned the size of the estimated surplus. "Those numbers change from day to day. Next week, we could have a deficit," he said (AP/Omaha World-Herald, 8/30).
  
  
• Kentucky: State officials and health care advocates have agreed to revisions to the state Medicaid program to help address a $675 million budget deficit, the AP/Cincinnati Enquirer reports. Under the revisions, the private health insurer that administers the Kentucky Children's Health Insurance Program would have to offer beneficiaries the same coverage state employees receive. The agreement also would limit the use of copayments in KCHIP (AP/Cincinnati Enquirer, 8/30). In a separate effort, state officials and mental health advocates met last month to address problems with a new pharmacy system that had denied prescriptions to some patients with mental illnesses. The state agreed to establish a hot line that physicians can call in the event of future problems (Yetter, Louisville Courier-Journal, 8/30).
  
  
• Missouri: Seven Missouri residents have filed a lawsuit against the state to block a proposal to eliminate Medicaid coverage for durable medical equipment, the St. Louis Post-Dispatch reports. Under the proposal from Gov. Matt Blunt (R), the state plans to eliminate Medicaid coverage of most durable medical equipment -- such as hospital beds, patient lifts and wheelchair batteries -- for 340,000 adults. The lawsuit alleges that the proposal is illegal because Missouri would eliminate Medicaid coverage of durable medical equipment for some beneficiaries but not others, such as children, blind beneficiaries, pregnant women or nursing home residents. In addition, the lawsuit alleges that the proposal is illegal because the state must provide "enough services to meet the health care program's goals," the Post-Dispatch reports. The National Health Law Program and nine other organizations helped draft the lawsuit, which seeks a temporary restraining order to block the proposal (Young, St. Louis Post-Dispatch, 8/29).
  
  
• New Hampshire: A legislative oversight committee on Tuesday voted 5-2 to approve Health and Human Services Commissioner John Stephen's Medicaid proposal, the AP/Foster's Daily Democrat reports (AP/Foster's Daily Democrat, 8/31). The proposal would allow the state to recover assets from or penalize Medicaid patients who transfer property at low prices to shed assets in order to qualify for the program. It also addresses income test exemptions for those who purchase long-term care insurance, the Manchester Union Leader reports (Fahey, Manchester Union Leader, 8/31). Stephen recently eliminated four other points in the proposal in response to concerns expressed by State Gov. John Lynch (D), providers, patient advocates and some legislators. The proposal now moves to the state Legislative Fiscal Committee. If the committee approves the plan, Stephen will send the proposal to CMS for approval (AP/Foster's Daily Democrat, 8/31).
  
  
• Ohio: State Medicaid officials have proposed cutting the pay of self-employed licensed practical nurses by 30% to reduce state and federal program costs by $8 million and prevent other cuts in services, the AP/Akron Beacon Journal reports. The state budget passed in June limits Medicaid growth to 4% annually, and officials are devising strategies for reducing projected spending by $2.3 billion. A recent review showed that Ohio Medicaid's Home Care Program paid LPNs more than they earned working in hospitals or nursing homes. The proposal is subject to approval by the state Joint Committee on Agency Rule Review, which likely will make a decision in October. If approved, the cut would take effect Jan. 1, 2006 (AP/Akron Beacon Journal, 8/29).
  
  
• South Carolina: The state chapter of AARP on Thursday criticized the state's proposed Medicaid reform plan, saying some state residents would lose health care benefits. The proposal would help reduce the state's Medicaid costs in part by creating personal health accounts for beneficiaries. According to the Charleston Post and Courier, seniors would be "among those who[would] be the least affected by the proposal as written." The plan does not include changes to long-term care or benefits for dual eligibles in South Carolina. However, AARP expressed concern that some provisions of the plan could be copied by other states. Bryan Kost, a spokesperson for the state Department of Health and Human Services, said the state welcomes input on the proposal, adding that the plan is a work in progress and can change (Maze, Charleston Post and Courier, 8/26).
  
  
• Tennessee: Advocates for TennCare beneficiaries have launched a statewide campaign calling for a special legislative session to consider ways to reverse cuts to the state's Medicaid managed care program, the AP/Knoxville News-Sentinel reports. The proposal by Gov. Phil Bredesen (D) would eliminate TennCare benefits for 190,000 beneficiaries and reduce benefits for others. Some advocates said state lawmakers could use a special session to find a better way to use money the state has earmarked to help those being disenrolled, while others called for taxes to keep beneficiaries in the program. A special session can only be called by the governor or with a two-thirds vote in the state Legislature (AP/Knoxville News-Sentinel, 8/29).