Christine Jordan Sexton
With one week left in the 2022 Legislative Session, it’s not clear whether the chambers will be able to reach an accord on a rewrite of the state’s mandatory Medicaid managed care law.
The House on Monday moved closer to passing the Medicaid managed care bill (SB 1950) but not before tagging on an amendment to the legislation that eliminated the Senate’s bill language and replaced it with the proposal (HB 7047) pushed by the House of Representatives instead.
Noting the amendment contained language that regional and statewide essential health care providers be required to sign contacts with all contacted Medicaid managed care plans, Rep. Nick Duran said it should be killed.
“If you … believe that competition has helped drive down prices and increase quality, particularly especially in the health care sphere, you should be alarmed by this amendment,” Duran said. “If you are concerned with a bloated government, you should be alarmed by this amendment.”
The House bill requires “essential providers” to enter into regional or statewide contracts with Medicaid managed care plans. The bill requires essential providers and managed care plans that can’t reach agreement to enter into mediation June 30. Mediators must submit a report to Agency for Health Care Administration (AHCA) by Oct. 1 showing the outcome of all mediation they presided over.
The state is required by Jan. 1 to withhold any supplemental payments from essential providers that do not have all the mandated contracts signed.
Duran pressed Rep. Sam Garrison, sponsor of the House Medicaid managed care bill, on whether the mediation requirement had any legal weight. Garrison admitted it did not. But he said the requirement that the mediator’s findings be made public will be beneficial to the “120 members of this body and the 40 friends across the hall … as to why we are not having a meeting of the minds,” Garrison said.
Duran also pressed Garrison as to whether the agency had discretion when it came to imposing financial penalties. Garrison admitted it does not.
Duran noted that the AHCA did not advocate for the language nor did the managed care plans nor the hospitals.
That essential provider mandate is a nonstarter for the Senate, according to top Republicans in the chamber. The House bill also would prevent Medicaid beneficiaries from being auto assigned into any managed care plan that has 50% or more market share.
“I would encourage us to maintain what the Senate has brought over here to keep this amendment off,” Duran said.
The chamber adopted the amendment on a voice vote and agreed to roll the bill to third reading for a vote on Tuesday.
The 2022 regular Legislative Session is scheduled to end Friday. AHCA wanted to pass a Medicaid managed care rewrite bill before it began working on new procurement documents.
