Panel caps therapeutic-leave Medicaid payment for PRTFs at $500 per day; bill cleared as amended

Chairman Vegasaw and members of the Appropriations Committee voted to amend and advance Senate Bill 2399, which would allow psychiatric residential treatment facilities (PRTFs) to receive a daily Medicaid payment for therapeutic leave days when a resident is temporarily away from the facility.

The amendment adopted by the committee sets a reimbursement cap: "reimbursements for therapeutic leave days may not exceed $500 a day," and requires the department to "implement utilization controls including service authorization for those therapeutic leave days," Representative Nelson said during the discussion.

The committee discussed the rationale for the cap against current North Dakota Medicaid average daily rates. Nelson noted that the average Medicaid daily rate in North Dakota is $1,199 and that the amendment effectively reduces the retainment payment roughly in half: "we didn't think it was fair to give them the full rate. So we cut it in half," he said. Committee members asked staff whether a revised fiscal note would be provided; a staff member identified as Alex said a new fiscal note would be requested and could take a couple of days to arrive.

Representative Nelson moved the amendment and Representative Mitscog seconded it; the amendment passed on a roll call recorded as 20 yes, 0 no, and 3 absent. Nelson then moved the bill, as amended; Representative O'Brien seconded. The committee voted to advance the bill as amended; the roll call recorded an outcome of 18 yes, 2 no, and 3 absent. Committee members noted the potential regional variations in daily rates and that the amendment was intended to standardize reimbursement across facilities.

The record shows the committee expects a new fiscal note to accompany the amendment before floor consideration. Representative Steeman was identified as the floor carrier for the bill as it moves forward.