CMS Administrator Mark McClellan Announces Clawback Reduction

With the recent release of the National Health Expenditures (NHE) growth rate, which is used in the calculation of the state contribution for dual eligibles in the Medicare Part D drug program, CMS has revised the clawback figures reflecting a $37 billion reduction from 2005 estimates. NCSL received a copy of a letter sent from Administrator McClellan to California Health and Human Services Secretary S. Kimberly Belshe regarding the recalculation of state clawback payments. The letter contains two charts providing a state-by-state breakdown of the new and old clawback amounts and reviews state intergovernmental transfer (IGTs) and recycling programs as of November 10, 2005.

Revised Enrollment NewClawback Comparisons

A

B

C

D

State

Annual Payments

Annual Payments

Old NHE w/ December
Actual Enrollment

New NHE w/ December
Actual Enrollment

Difference
(C-B)

Alabama

$19,040,841

$17,202,153

$(1,838,687)

Alaska

$65,599,530

$59,264,881

$(6,334,648)

Arkansas

$33,815,887

$30,550,440

$(3,265,447)

Arizona

$57,615,285

$52,051,639

$(5,563,646)

California

$1,172,151,995

$1,058,962,604

$(113,189,391)

Colorado

$72,876,673

$65,839,304

$(7,037,369)

Connecticut

$124,059,021

$112,079,205

$(11,979,816)

Delaware

$14,025,128

$12,670,785

$(1,354,343)

District of Columbia

$10,975,558

$9,915,699

$(1,059,860)

Florida

$479,984,275

$433,634,375

$(46,349,900)

Georgia

$130,984,275

$118,344,013

$(12,649,443)

Hawaii

$22,175,070

$20,033,724

$(2,141,346)

Idaho

$18,060,946

$16,316,883

$(1,744,063)

Illinois

$333,221,963

$301,044,232

$(32,177,731)

Indiana

$99,283,770

$89,696,387

$(9,587,382)

Iowa

$66,174,915

$59,784,704

$(6,390,211)

Kansas
$48,756,251

$44,048,082

$(4,708,170)

Kentucky
$81,122,635

$73,288,990

$(7,833,644)

Louisiana
$82,793,438

$74,798,452

$(7,994,986)

Maine
$45,260,376

$40,889,787

$(4,370,589)

Maryland
$92,240,710

$83,333,444

$(8,907,266)

Massachusetts
$239,970,806

$216,797,916

$(23,172,890)

Michigan
$188,540,434

$170,333,941

$(18,206,493)

Minnesota
$109,733,219

$99,136,780

$(10,596,438)

Mississippi
$76,553,279

$69,160,877

$(7,392,402)

Missouri
$191,708,376

$173,195,969

$(18,512,407)

Montana
$12,238,192

$11,056,405

$(1,181,787)

Nebraska
$41,619,392

$37,600,396

$(4,018,996)

Nevada
$22,496,284

$20,323,920

$(2,172,364)

New Hampshire
$30,585,921

$27,632,378

$(2,953,543)

New Jersey
$271,291,722

$245,094,314

$(26,197,409)

New Mexico
$18,845,259

$17,025,458

$(1,819,801)

New York
$779,819,148

$704,515,557

$(75,303,591)

North Carolina
$247,898,287

$223,959,876

$(23,938,411)

North Dakota
$5,458,968

$4,931,821

$(527,148)

Ohio
$230,584,176

$208,317,710

$(22,266,466)

Oklahoma
$55,382,475

$50,034,441

$(5,348,034)

Oregon
$63,234,635

$57,128,354

$(6,106,281)

Pennsylvania
$399,667,987

$361,073,866

$(38,594,121)

Rhode Island
$41,678,993

$37,654,242

$(4,024,751)

South Carolina
$77,385,665

$69,912,883

$(7,472,782)

South Dakota
$12,956,089

$11,704,978

$(1,251,111)

Tennessee
$283,931,372

$256,513,410

$(27,417,962)

Texas
$303,361,506

$274,067,264

$(29,294,242)

Utah
$21,471,442

$19,398,042

$(2,073,400)

Vermont
$18,454,617

$16,672,538

$(1,782,078)

Virginia
$166,965,498

$150,842,399

$(16,123,099)

Washington
$145,340,530

$131,305,656

$(14,034,874)

West Virginia
$30,780,689

$27,808,337

$(2,972,351)

Wisconsin
$145,195,338

$131,174,484

$(14,020,854)

Wyoming
$8,358,727

$7,551,563

$(807,164)

Total Percentage
Reduction
$7,311,736,748

$6,605,675,559

$(706,061,189)
-9.66%

For further information, please call NCSL staff Joy Johnson Wilson, Health Policy Director at 202-624-8689 or Rachel Morgan RN, BSN, Senior Health Policy Specialist at 202-624-3569.