July 21, 2004

Pryce Praises Approval of Medicaid Plan to Enhance Care for Ohioans with Chronic Illnesses

WASHINGTON – U.S. Rep. Deborah Pryce (R-OH-15) praised an innovative plan unveiled today by the Centers for Medicare and Medicaid Services (CMS) called “Enhanced Care Management” that will improve quality of care for Medicaid enrollees in Ohio who suffer from chronic and life-threatening diseases.  The new system will assign case managers to nearly 25,000 Medicaid enrollees by the end of next year. 

The approved voluntary plan, announced by CMS Administrator Mark B. McClellan, M.D., will assist aged, blind or disabled consumers with specified conditions such as diabetes, congestive heart failure, coronary artery disease, asthma, chronic obstructive pulmonary disease and non-mild hypertension.  Children under age 21 who have asthma will also be covered.

“This innovative program will go a long way toward providing Ohioans suffering from chronic and life-threatening illnesses with new tools and resources to help them manage their conditions,” Pryce said.  “Putting in place case managers to help individuals navigate the complex health care system and ensure they’re receiving the right kind of care is just what we need to keep people healthy and avoid the need for expensive treatments and hospitalizations.”

In addition to direct assistance with the management of their specific health care needs, participants in the program will also receive:   

  • access to a 24-hour nurse helpline;
  • an enhanced care monthly Medicaid card that allows them to obtain their medical services; 
  • access to all of the medically necessary services that are covered by the Medicaid benefit package;
  • the right to cancel membership in the ECM program at any time; and
  • no co-pays.

Medicaid is a state/federal partnership program created in 1965 to provide health care services to certain low-income persons such as children, pregnant women, aged, blind and disabled Americans.  According to CMS, Medicaid currently serves over 41 million people.  Together, states and the federal government spent $276 billion on the Medicaid program in fiscal 2003

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