Committee hears testimony on Medicaid Access Program that would raise provider rates through covered‑lives assessment

The House Appropriations Committee received testimony on House Bill 13 92, a proposal to establish a Medicaid Access Program that would increase Medicaid professional service rates by using a covered‑lives assessment to fund the nonfederal share of state‑directed payments to managed care organizations (MCOs).

Under the bill as amended in committee staff briefing, the Healthcare Authority (HCA) would submit the state plan amendments or waiver requests to the Centers for Medicare & Medicaid Services (CMS) necessary to implement the program. The program may begin only with CMS approval. For assessments collected in the first plan year, the bill sets a cap of no more than $18 per covered life per month on assessments for Medicaid MCOs and no more than $0.50 per covered life per month assessed by the Office of the Insurance Commissioner (OIC) on health carriers. Assessment revenue would be deposited into a newly created Medicaid Access Program Account, which would fund…