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Committee hears bill letting DPHHS adopt Medicare fee schedules automatically
Summary
Representative Jane Gillette told the House Health and Human Services committee HB 473 would allow the Department of Public Health and Human Services to adopt Medicare fee schedules by rule so CMS updates are incorporated automatically; DPHHS said the change would reduce duplicate claim work and avoid a mass-adjust of 109,732 claims in 2024.
Representative Jane Gillette, sponsor of House Bill 473, told the House Health and Human Services committee the bill would let the Department of Public Health and Human Services adopt Medicare fee schedules issued by the Centers for Medicare & Medicaid Services by rule, allowing the department to automatically incorporate CMS updates.
"This bill basically what it does, it's an agency bill and it basically allows DPHHS to use the Medicare fee schedule...as an efficiency," Gillette said, explaining the bill text permits the department to "adopt by rule Medicare fee schedules issued by CMS" and to have those schedules "automatically incorporate changes and updates furnished by CMS." She asked the committee to pass the bill.
Mary Lemieux, administrator for the Health Resources Division at DPHHS, testified the department supports HB 473. She said automatic adoption would ensure services affected by Medicare fee schedules are reimbursed at correct rates and would reduce duplicate work for the department's fiscal agent. Lemieux told the committee that delayed adoption in 2024 forced the department to mass-adjust 109,732 claims and that many of those claims required manual review, tying up staff time.
Katie Hawkins, a subject-matter expert in DPHHS's Allied Health Services Bureau, accompanied Lemieux to answer technical questions on affected services. Duane Pressinger of the Montana Hospital Association also urged approval, saying the bill "helps providers get paid earlier and also saves the department and their claims processing system a lot of time."
No opponents or informational witnesses spoke in opposition to HB 473 during the hearing. Representative Gillette closed by asking members for a favorable vote. The committee closed the HB 473 hearing and a DPHHS representative requested a "due pass."
