Committee reviews bill to create Medicaid billing category for university-run behavioral health clinics

Senate Bill 353, presented by Senator Marilyn Dondero Loop, would require Nevada Medicaid to establish a new billing category within the Medicaid Services Manual, to be used by clinics run by accredited Nevada universities or their faculty practice plans that provide mental and behavioral health services under medical direction. The bill also would authorize two separate all-inclusive per-diem reimbursement rates for services provided by certain trainees during visits to those clinics and requires the Department of Health and Human Services (Nevada Medicaid) to seek federal authority as needed to implement the change.

"This category is intended for clinics operated by an accredited university within Nevada or pursuant to a faculty practice plan...that provide under the direction of medical," the sponsor said in explanation to the committee. The bill directs DHHS "to apply for any waiver or Medicaid state plan amendment or other federal author authorities to carry out the bill's provisions," language that committee members pressed staff to clarify.

Anne Jensen, innovation officer for Nevada Medicaid, told the committee that the change would require federal authority via a state-plan amendment rather than a CMS waiver: "Based on our understanding, this would require a state plan authority. So it would not be a waiver, but we would have to seek federal authority from CMS," Jensen said, noting the process can be lengthy and that Washington state is pursuing a similar approach.

The Department of Health and Human Services submitted a fiscal note estimating an impact of over $680,000 across the upcoming biennium. The sponsor noted the committee had before it a conceptual amendment addressing funding mechanics: some portion of the Medicaid-related costs could be covered by provider assessment revenues rather than general fund. "Because of the nature of Medicaid patients … we're able to use some of those provider tax fees in order to cover these Medicaid portion of the things," the sponsor said during committee discussion.

University and provider groups testified in support, including the Nevada Psychiatric Association, Nevada System of Higher Education, and representatives from UNLV and other academic institutions. No opposition testimony was offered at the hearing.

The committee closed testimony and the sponsor read a conceptual amendment that would transfer certain assessment revenues and authorize corresponding federal funds to support implementation; no final committee vote was recorded during the hearing.