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Feds: Utah can reward Medicaid patients for healthful moves

Published January 26, 2012 12:29 pm

Health care • Feds reverse initial rejection of a part of Utah's plan to reform the program.
This is an archived article that was published on sltrib.com in 2012, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Rewarding Medicaid patients for making healthful choices can be part of Utah's reform plans for the program, federal officials have decided, reversing their earlier rejection of the idea.

The Centers for Medicare and Medicaid (CMS) has endorsed a wellness plan that would entail giving patients incentives for complying with their doctor's orders, such as gift certificates to a baby store for moms who make all their prenatal care appointments.

CMS initially rejected the idea, along with other parts of Utah's 91-page blueprint for reforming Medicaid. It cited laws that prohibit federal Medicaid dollars from being used to purchase anything but medical care.

But last week they changed their minds, said Utah Department of Health spokeswoman Kolbi Young.

CMS wouldn't budge, however, on other points.

The feds buy into the core principle of steering patients into managed care networks. But they won't let the state impose higher co-payments on patients — a tool that the state had hoped to use to discourage patients from misusing emergency rooms.

Also denied: a tool for cutting the use of high-cost, unproven treatments, similar to a strategy adopted more than a decade ago in Oregon; and a plan to allow eligible Utahns to forgo Medicaid in favor of subsidies to purchase private health policies on the state's Health Insurance Exchange.