Medicaid chief leaves, but savings plan in limbo-WEB ONLY

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Dr. Jeff Wells is moving on from the Indiana Medicaid program even as his $40 million cost-savings plan faces a threat in the General Assembly.

Wells resigned Friday after two years as director of the Office of Medicaid Policy and Planning, a part of the Indiana Family and Social Services Administration.

He intends to finish his medical residency at the Indiana University School of Medicine in Indianapolis.

FSSA Secretary Anne Murphy appointed Pat Casanova as Wells’ interim replacement. Casanova has been serving as Medicaid’s director of agency coordination, integration and policy.

“This has been a great experience and I am grateful for the opportunity,” Wells wrote in an e-mail sent to colleagues.

Meanwhile, the Indiana House of Representatives passed language as part of the budget bill that would block Wells’ effort to save millions by consolidating pharmaceutical purchases for Medicaid patients.

To centralize drug buying, Indiana Medicaid would take away that responsibility from the insurance companies it hires to administer Medicaid benefits for nearly three-quarters of the program’s 800,000 patients.

Those three companies are Indianapolis-based MDWise Inc.; Managed Health Services, a unit of St. Louis-based Centene Corp.; and WellPoint’s Indianapolis-based subsidiary, Anthem Blue Cross and Blue Shield.

Buying and managing pharmaceuticals represents about 15 percent of the value of their contracts.

But federal law requires drug companies like Eli Lilly and Co. to give discounts to state Medicaid programs. Those discounts average about 35 percent – much higher than what the insurers are able to negotiate with drug companies.

Medicaid needs those savings, Wells said in a February interview, or else it will have to cut its payments to physicians, hospitals, nursing homes and other providers 5 percent.

“It’s really simply a trade-off on a one-to-one level,” Wells said.

Sen. Patricia Miller, R-Indianapolis, dealt with the issue in her committee on Health and Provider Services – without coming to a firm decision. Physicians may be hurt without Medicaid’s plan, but drug companies and perhaps health insurers could be hurt by it.

“We’re going to work through all this. I’m not ready to come down in concrete one way or another,” she said.

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