Rules committee advances conference report on House Bill 1003 after debate on site-of-service implementation and Medicaid data sharing

Representative Barrett presented the conference committee report for House Bill 1003 and described three components of the report: parallel language on prior authorization, partial restoration of contracting language removed by the Senate to promote competitive contracting, and provisions intended to facilitate implementation of a 2023 site-of-service policy. "I present conference committee report number 1. And there are 3 features of this, report," Representative Barrett said.

Barrett said the site-of-service provisions respond to shortcomings in the Department of Health's ability to implement language from a prior bill. "This was really not a, debate on the policy, but rather just a mechanism that would promote implementation of that policy," Barrett said, adding the conference committee had met with stakeholders to reach workable language.

Committee members pressed Barrett on a provision that would allow the attorney general's office to execute data-sharing agreements to aid Medicaid fraud investigations. Representative Pierce said the possibility of personal data being shared "makes some people nervous" and asked what types of information investigators might seek. Barrett described a range of potentially relevant data sources mentioned in the conference discussions, including address information and photos from the Bureau of Motor Vehicles (BMV), vehicle and home values, Department of Revenue information and other records that could help identify duplicate enrollments or asset mismatches. "There were multiple sources of information that could help make determinations in an arena where assets and income are part important," Barrett said.

Barrett framed the effort as part of multiple attempts to address budgetary pressure in Medicaid, saying the provisions aim to "add efficiency and accuracy" after what he described as a large budget shortfall. He cited a "$2,400,000,000 shortfall in the budget" and earlier forecast errors the committee discussed while describing the rationale for stronger fraud-detection tools.

Several committee members, including Representative Dvorak, suggested limiting access so the information is used specifically by the Medicaid fraud unit rather than more broadly by the attorney general's office. "I think it were drafted in a way, say, this information sharing can happen for the use of the Medicaid fraud unit, not just sort of for the blanket use by the attorney general," Dvorak said.

After discussion Representative Slager moved to suspend House Rules 153.1 and 155.1 to make the conference committee report eligible for consideration after April 15, 2025, and to permit member distribution with a 12-hour hold. The motion passed on a roll call, 7 to 2. Chairman Smoltz and representatives Slager, Baird, Karakoff, Manning, Oltoff and Zimmerman voted yes. Representatives Dvorak and Pierce voted no. Representative Johnson was recorded as excused.

What the bill does: the conference committee report (as presented) does three things: 1) mirrors prior-authorization language from Senate Enrolled Act 480 to maintain consistency; 2) restores roughly three-quarters of contracting language that had been in the House version to promote competition in contracting; and 3) adds implementation-focused language to support execution of site-of-service policy adopted in 2023 (House Bill 1004) after the Department of Health reported difficulty meeting initial implementation timelines.

No final substantive policy was enacted at the rules meeting; the committee's action was procedural, enabling floor consideration after the specified date and allowing members time to review the report.

Votes at a glance: Motion to suspend rules and make the conference committee report for House Bill 1003 eligible for consideration after April 15, 2025 — Passed 7 to 2 (roll call listed above).