Harvey Peeler

Yesterday HHS director Tony Keck met with the Finance Committee to give us some disturbing news. This is why last week I introduced a resolution suspending the budget provisos tying Keck’s hands as he enters his new job. We need to give him as much flexibility as possible to tackle this massive problem.

By Yvonne Wenger
COLUMBIA — The state Medicaid director told lawmakers Tuesday he needs $228 million in the next several months or South Carolina is going to have to cut loose hundreds of thousands of poor, disabled and elderly residents who rely on the state for health care.

Tony Keck’s testimony before House and Senate budget writers sets the stage for a major clash over how the state will pay its bills, given the alternative of being the only state in the nation to consider withdrawing from the federal Medicaid program.

The decision to allow the Department of Health and Human Services to operate with a deficit will be made next week by the Budget and Control Board, which is chaired by Gov. Nikki Haley, who has not yet revealed where she stands on allowing her Cabinet agency to operate in the red.

State lawmakers, chiefly Senate President Pro Tem Glenn McConnell, R-Charleston, have insisted the agency find a way to make do with the cash the Legislature allocated and not come back for more.

Keck was put in the hot seat on his fourth day in the job.

“I didn’t come here on a suicide mission,”

Keck told lawmakers. “I came because it was my assessment that South Carolina is poised to do some really remarkable things.”

Lawmakers indicated that the state could shift to the Medicaid program an extra $300 million in tax collections that the state government is now projected to collect above original budget estimates.

And to prepare for another deficit at the Health and Human Services Department next budget year, lawmakers are considering allowing the agency to cut the rates it pays doctors, hospitals and nursing homes that treat Medicaid patients. The agency’s budget shortfall for the upcoming fiscal year that begins July 1 could reach nearly a half a billion dollars.

The Legislature has protected those rates during the economic downturn, for fear the providers would stop treating Medicaid patients if the state paid them less. But Keck said he needs the flexibility to run his agency, which saw another 4,800 people enroll in Medicaid last month alone.

Keck said that if lawmakers give the agency flexibility, it will give him a bargaining tool to help control costs. Keeping every health care provider in business should not be the state’s goal, Keck said. Instead, the goal should be keeping the system stable and using the least amount of tax dollars necessary to create a healthy population, he said.

Keck did not provide a road map on how the agency will handle the massive budget shortfalls. He did, however, lay out plans to change the way the system operates to make it more efficient. He also insisted that South Carolina can’t rely on budget cuts alone to come up with a solution.

In outlining his sweeping goals, Keck said he will evaluate whether the state is spending its money in the right places, determine how much South Carolina is paying for health care and investigate elements of the state’s Medicaid programs, such as the use of managed-care organizations. Specific ways to address costs could include forcing health care providers to look at their staffing ratios, raising patient co-pays within the confines of federal restrictions, and pushing for tort reform on medical malpractice suits, Keck said.

Keck’s hands are tied by the federal government in terms of making significant changes to the Medicaid program. Haley has directed him to draft options she can take to President Barack Obama to allow South Carolina to opt out of the new federal health care law, which is being challenged in federal court. Keck said the governor has told him to report back to her as soon as possible.

Sen. Phil Leventis, D-Sumter, cautioned Keck to remember that lives hang in the balance, as he makes decisions to run the Medicaid agency.

“It’s not a toolbox; it’s people and it’s tax dollars and it’s the investment we make in health care,” Leventis said.

Courtesy of The Post and Courier