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House approves targeted continuous‑eligibility pilot for Medicaid to support preventive care
Summary
HB98 passed unanimously to permit managed‑care carve‑outs and continuous eligibility for specific Medicaid populations (for example, chronic‑care and prenatal groups) where providers assume risk and can pursue preventive models intended to improve outcomes and reduce costs.
The Utah House on Feb. 15 passed House Bill 98 to allow the Department of Health and managed‑care plans to test targeted "continuous‑eligibility" approaches and carve‑outs for Medicaid subpopulations where preventive care and stable enrollment can improve outcomes and reduce long‑term costs.
Representative Sanpai (floor presenter) said the bill enables the state to permit managed‑care contracts in which providers accept risk and are rewarded for improving outcomes; the policy specifically carves out only those patient populations where proven preventative treatments exist so that the state does not incur unnecessary expenditures. "Continuous eligibility simply means that...an individual, once they present with an issue, would remain would maintain eligibility for a fixed period of time," the sponsor explained.
Supporters on the floor, including Representative Briscoe in questioning, sought clarification on topics such as whether the bill encourages group approaches to care (accountable care or medical homes). The sponsor said the mechanism focuses on carve‑outs and managed‑care contracting to allow innovation without increasing state spending.
The measure passed the House 70–0 and was transmitted to the Senate. The sponsor said the bill delegates substantial implementation work to the executive branch and encourages further administrative development of pilot programs.
