The South Dakota Board of Social Services learned more Tuesday about state government’s effort to spread Medicaid dollars farther.
Officials said there’s $4.6 million being spent in other ways in Medicaid this budget year.
That’s because the federal government is fully reimbursing on more Medicaid services to American Indian patients for care outside the federal Indian Health Service system.
A change in federal law in 2016 made it possible.
Community providers are getting about $2.7 million more. Another $1.2 million is filling gaps in services. And providers and IHS are also sharing $630,000 of the savings.
Normally, the federal government pays 100 percent of the costs for American Indian patients if they receive IHS care.
But state government pays 45 percent many times when American Indians go outside the IHS system.
South Dakota spent about $97 million for Medicaid care to American Indians in 2017, according to Brenda Tidball-Zeltinger.
She is a deputy secretary for the state Department of Social Services.
The group working on the project is the Health Care Solutions Coalition. Its members are from tribal governments, the Indian Health Service, state government and health care organizations.
Its co-chairs are Jerilynn Church, executive director for the Great Plains Tribal Chairmen’s Health Board, and Kim Malsam-Rysdon, state secretary of health.
The group has several subcommittees focused on different areas.
Tidball-Zeltinger said the second one is drafting a Medicaid waiver. It would allow the three major health care providers and the two largest dialysis services to serve more people and stay open more hours.
That would reduce the patient load for emergency rooms. The goal for the waiver is to be revenue neutral.
“The focus for us will be the Medicaid population,” Tidball-Zeltinger said. “I think we’ll be able to bear fruit from this.”
Board Chairman Hugh Grogan of Sioux Falls said he was disappointed the coalition’s original purpose of expanding eligibility for Medicaid wasn’t met. But Grogan praised the new directions the coalition is taking.
Said Social Services Secretary Lynne Valenti: “There’s been really good consensus from the group.”