Legislators turned to Medicaid provider rates, always a tough policy topic, this week.
The six members of the Joint Budget Committee (JBC) met with executives from the Department of Health Care Policy and Financing (HCPF) on Tuesday to discuss a proposed JBC bill (House Bill 1151) that would raise all Medicaid reimbursement rates to at least 60 percent of Medicare rates. If there aren’t any comparable Medicare rates, Medicaid reimbursements would be raised to the average fair market rate. Before a temporary hike in Medicaid rates that was funded under the Affordable Care Act, Colorado doctors treating Medicaid patients were paid about 71 cents for every dollar they would have received for providing the same services to Medicare enrollees. Many believe that the lack of parity in reimbursements has contributed to problems with health care access for Medicaid enrollees, though the degree to which payment levels affect access is unknown.
The $16.5 million budget request for this year’s targeted rate increases would focus on the most unequitable rates and those most responsible for limiting access to care. It would not raise Medicaid rates across the board. HCPF leaders said they need more time to figure out how much that would cost. After many questions from JBC members, the meeting ended without any decisions.
This afternoon, we’ll be watching two health committee hearings. The House Health, Insurance & Environment Committee will be considering House Bill 1128, which would apply strict new regulations to abortion providers. Among the proposed regulations: that all abortion clinics must have a doctor on staff with admitting privileges at a nearby hospital. The committee will also consider House Bill 1141, which would require that the hospital provider fee be listed on patient billing statements. The fee was established by legislation in 2009 (House Bill 09-1293). HCPF collects the money from hospitals and uses the revenue to enable federal matching funds for Colorado’s Medicaid program. Proponents argue that this would improve transparency around health care costs, while opponents say that it would confuse patients and increase administrative expenses.
Simultaneously, the Senate Health and Human Services Committee will be considering House Bill 1039, which comes to the Senate after passing the House on January 26. The bill makes it easier to donate unexpired medications and supplies to nonprofits. Senate HHS will also hear Senate Bill 123, which would allow patients to choose any pharmacy in their network to fill a prescription. The committee has delayed a hearing on medical marijuana (Senate Bill 14).
An interesting bill has dropped off today’s House calendar. House Bill 1143 aims to create tax credits for seniors for home health care equipment and services. The bill, sponsored by Rep. Kathleen Conti (R), was assigned to three different committees, with its first hearing in House Health, Insurance & Environment.
The issue is intriguing, especially in light of the growing focus on helping people to age in their homes, an environment that is generally more comfortable and more affordable than nursing homes or hospitals. Researchers are studying the impacts of initiatives such as the CAPABLE project in Baltimore, which is making relatively low-cost improvements to the homes of seniors in an effort to extend their time at home, and states across the country are grappling with the issue. HB 1143 does not yet have a fiscal note, so we are waiting to see the up-front cost of this proposed tax credit.
We expect a flurry of late bills to be introduced at the end of February or even the beginning of March, including bills to expand the scope of practice for advanced practice nurses and dental hygienists.