The Select Committee on Efficiency in Government is charged with looking at areas of efficiency and effectiveness in health care access, delivery, and affordability. At its August 2011 meeting, the committee created a subcommittee on Medicaid to gather more information and ideas for efficiencies in the Medicaid program. The subcommittee met four times to review suggested changes to Medicaid and other health care laws and administrative rules.
In May 2012, the full committee reviewed and took public comment on six bills drafts. Members approved five of the measures for introduction in the 2013 Legislature, after approving revisions to some of the bill drafts. The committee approved legislation to:
revise the Medicaid application and eligibility determination process;
impose a penalty on people who receive assets that were improperly transferred by a person who applies for Medicaid coverage of long-term care costs;
revise certain elements of the 72-hour presumptive eligibility program for mental health crisis stabilization services;
require the Department of Public Health and Human Services to measure and report on outcomes for children's mental health services; and
establish a four-year effort to develop and put in place a pay-for-performance pilot project for children's mental health services.
At the May meeting, members tabled a draft bill to eliminate unit billing for certain targeted case management services. However, members later agreed to hear a revised proposal and in September 2012 approved as committee bills measures to:
appropriate $5.7 million in state and federal funds in the next biennium to increase the reimbursement rate for children's mental health targeted case management services; and
establish a nine-member advisory committee to work with DPHHS on developing a monthly reimbursement rate for adult and children's Medicaid mental health targeted case management services that better reflect the actual costs of providing services.
The committee also agreed to recommend to the 2013 Legislature that it limit the appropriation for utilization review of Medicaid children's mental health services to only those services for which such review is required under federal law. Members asked that DPHHS be notified of the letter so the agency was aware of the potential change as it finalized a contract for the utilization review services. DPHHS replied to the committee's letter in June.
The committee reviewed the following bill drafts at the May 2012 meeting:
In September 2012, the committee also reviewed the following bills:
LCSC13: Appropriate Funds to Increase Children's Mental Health Targeted Case Management Rates
LCSC14: Create Advisory Committee on Cost-Based Reimbursement for Targeted Case Management Services
The committee made revisions to some of the drafts and approved all but LCSC12 for introduction in the 2013 Legislature. The final versions of the bills, along with the official "LC" number assigned to them for the session, are available on the committee's Proposed Legislation page.