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[source: NativeNews; Fri, 11 Feb 2000 09:34:36]

New policy drops American Indians from health plans http://www.abqtrib.com/news/020900_salud.shtml
By Nancy Salem Tribune reporter

Thousands of American Indians in New Mexico who were automatically enrolled in Medicaid managed-care plans have been dropped from those plans under a state policy that went into effect Jan. 1.

Under the old policy, American Indians could choose a provider in Salud!, the state's Medicaid managed-care program. Those who didn't choose a provider were automatically enrolled in either the Presbyterian, Lovelace or Cimarron health plans.

American Indians who chose a particular managed-care plan will remain in those plans under the new policy. But those who didn't choose and were automatically enrolled are being dropped from those plans unless they specifically ask to be left in.

American Indians can opt in to Salud! at any time under the new policy. Those who choose not to participate in Salud! will receive service under fee-for-service Medicaid. American Indian Medicaid clients also can receive care at Indian Health Service facilities whether or not enrolled in Salud!

"This policy reflects an earlier agreement made with Native American tribal leaders in New Mexico," said Robin Dozier Otten, secretary-designate of the state Human Services Department. "Although it is too early to tell how many Native Americans are choosing to remain in Salud!, I hope that expanding choices will result in better health care for people."

Medicaid is the state and federal partnership that pays the medical expenses of low-income people. The Salud! managed-care program was phased in statewide in 1997, replacing a fee-for-service system in which doctors and hospitals billed the state for services rendered. Gov. Gary Johnson has said the state saved about $400 million by switching to a managed-care system.

The Presbyterian, Lovelace and Cimarron managed-care organizations were given contracts to administer the Salud! program.

Cimarron has so far been hardest-hit by the new policy, losing 5,739 of its nearly 8,000 American Indian Salud! members. Lovelace has lost 530 of its 4,800 American Indian Salud! members and Presbyterian has lost about 4,000 of its 16,000 members. There are about 300,000 Salud! clients in New Mexico.

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