BCBS PROGRAM TO AID CHILDREN WILL CLOSE IN FALL; STATE'S MEDICAID EXPANSION TO COVER HEALTH CARE COSTS

Expansion of Missouri's Medicaid program is putting the Caring Program for Children, a private, non-profit health care foundation, out of business.

The Caring program, established in 1987 by Blue Cross and Blue Shield of Missouri to provide free health care for children whose families could not afford private health insurance, will shut down in October, said executive director Lee B. Michelson.

"We really, at this point, have completed our mission," Michelson said.

Since its establishment, the Caring program has served more than 25,000 Missouri children, he said.

The expansion of the Medicaid program, which took effect July 1, will add about 90,000 children to the rolls.

Under Senate Bill 632, the state will allow children 19 and younger whose families' income is within 300 percent of federal poverty guidelines to receive medical treatment through Medicaid.

Under the new law, a family of four with a maximum income of $48,000 could qualify for Medicaid assistance for their children.

Michelson said the Caring program will continue to provide health care for the children of the working poor until October and will work with Medicaid officials to make sure their clients' transition to the state program is smooth.

"We like to think that Medicaid has finally come around to take care of the kids that we had served because they were not," Michelson said. "Now they've seen that working poor children need help."

Health care access for the new group of Medicaid clients remains a question.

Many Medicaid recipients already complain that they can't find doctors and dentists who are accepting new Medicaid patients.

The heavy amount of paperwork and low reimbursement rates associated with the program may prevent many doctors from participating in the program.

But Gregory Vadner, director of the Missouri Division of Medical Services, which administers the Medicaid program, said the state is taking steps to bring more physicians into the program.

This fiscal year, the state has enacted a "significant fee increase" for physician reimbursement, which should help make Medicaid more attractive to physicians, he said.

The new state budget includes more than $10.8 million for increased reimbursement for medical services, Vadner said.

"That's the first fee increase of any significance in quite a few years," he said.

The state has focused on increasing reimbursement for procedures that have traditionally been underpaid, Vadner said.

"It's not a blanket percentage increase," he said.

The increases include an additional $2.3 million for hospital visits, $4.9 million for office visits, $463,295 for surgical procedures, and $3 million for anesthesia.

The state also is working with the Missouri Hospital Association to find ways to bring more physicians into the program, Vadner said.

And MC+, the managed care arm of Medicaid, has also increased the number of physicians participating in the program, he said.

MC+ is not yet available in Southeast Missouri.

Michelson said the Caring program is encouraging its health care providers to keep seeing its clients after they switch to Medicaid coverage to provide continuity of care.

"I'm hoping they'll have the same doctors that they've been seeing up to now," Michelson said.