Agency of Human Services seeks $29.1M in midyear budget adjustments, advances Medicaid prospective payments for hospitals

The Agency of Human Services on Jan. 21 told the Appropriations Committee it is requesting a $29,100,000 midyear budget adjustment to cover Medicaid caseload and utilization pressures, support hospital transformation work and provide one‑time relief and transition funding for providers.

For the record, Secretary Jenny Samuelson, secretary for the Agency of Human Services, said the agency’s total appropriation across all funds this fiscal year is about $5.4 billion, with roughly $1.3 billion in state general fund. “What we have seen, in this past year is that the caseload, as we predicted it is following predictions, but utilization of health care services is up,” Samuelson said, attributing the primary pressure to higher use of services rather than unexpected enrollment growth.

The budget adjustment package includes several major elements. Rich Donahue, chief financial officer for the Agency of Human Services, described a Medicaid consensus caseload and utilization projection that requires $83.5 million gross and $35.5 million in general fund for the current year; pharmacy rebates and other offsets reduce some of that pressure. Donahue also identified a $24.5 million gross ($10.4 million general fund) increase tied to nursing‑home utilization returning toward pre‑pandemic levels, and a $1.9 million gross need in the Department of Mental Health for private non‑medical institution payments.

The agency also described requests to support hospital transformation and payment…