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Senate hears extensive presentation on Medicaid waiver reauthorization and proposed changes to work requirements, pharmacy rebates and medical loss ratio
Summary
Senate Bill 527 would reauthorize the state's Section 1115 Medicaid waiver (the ARHome program) and propose pharmacy rebate tracking, a raise of the medical loss ratio to 90%, and optional work/volunteer provisions contingent on CMS approval, sponsors said.
Senate Bill 527, described by Sen. Missy Irvin as a reauthorization of a Medicaid Section 1115 waiver (the state’s ARHome program), drew extended committee discussion on pharmacy‑rebate transparency, a proposed rise in the medical loss ratio (MLR) from 80% to 90%, and a work‑and‑volunteer requirement that would be implemented only if approved by the Centers for Medicare & Medicaid Services (CMS).
Irvin said the bill would capture pharmacy rebates for the state, change the MLR metric from 80/20 to 90/10, and add eligibility for federally…
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