Senate committee reviews H.13, a bill ordering regular rate studies for community‑based Medicaid providers

Senate Appropriations Committee members on April 11 heard a staff presentation on H.13, a bill that would require the Agency of Human Services (AHS) to determine and report reasonable and adequate Medicaid payment rates for community‑based service providers.

The bill “would require the AHS secretary to redetermine the payment rates at least annually and report them in the amounts necessary to fund them to legislative committees' jurisdiction,” said Jen Perry of the Office of Legislative Council, describing the bill's principal reporting and rate‑study requirements.

Why it matters: proponents told the committee the measure aims to give lawmakers consistent, transparent data on what Medicaid payment rates should be and how much it would cost to fund them, rather than requiring immediate appropriations. Perry said the bill directs the secretary to “conduct rate studies of Medicaid rates to these providers, at least once every 5 years for each provider type,” adopt a methodology and predictable timelines, and set an annual process for inflationary adjustments.

What the bill does and does not do: Perry and staff emphasized that H.13 creates a statutory process for rate determination and for extraordinary financial relief if a provider faces imminent closure, but it does not itself appropriate funds or force AHS to increase payments. “It does not actually require them to be funded at that rate unless the legislature appropriates the funds,” Perry said. Committee staff reiterated that the bill would place rate findings into AHS’s budget presentations so appropriations decisions would be informed by the studies.

Scope and terminology: the amendment discussed in committee replaces the Medicaid statutory term “home and community‑based services” with the broader phrase “community‑based services” after AHS requested different wording because the federal Medicaid definition differs from the broader group of providers the bill intends to cover. Perry said the bill would add a new definition in the chapter on health care facility rate setting and would fold designated and specialized service agencies into the community‑based services definition in Title 33.

Questions and next steps: committee members asked about overlap with language in the budget that also calls for a study of community‑based organizations; members instructed staff to reach out to House colleagues to reconcile possible duplication. A committee member asked staff to “reach out to house folks and try to get a sense of what why that language is in there,” and staff agreed to report back. Members asked for the fiscal office to refine the fiscal note and the committee agreed to hold final action pending that follow‑up, with one member asking to delay a vote until the committee received additional clarification by Tuesday.

Background: proponents said rate studies would provide data to evaluate provider requests during annual budget deliberations and could identify the cost to bring rates “up where they belong based on economic” conditions, but any increase would require separate legislative appropriation.

The committee did not take a recorded vote on H.13 during the session covered here; members requested additional coordination with the House and supplemental fiscal information before a final Senate position.