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Senate OKs Mental-Health Systems Bill, But Lawmakers Flag County Cost Concerns
Summary
The Utah Senate passed first substitute Senate Bill 161 to require Medicaid-contracted plans to reimburse behavioral telemedicine at in-person rates and to prevent discipline for providers seeking treatment; senators raised concerns that counties could face roughly $267,000 in added costs per county absent fiscal adjustments.
The Utah State Senate on Feb. 22, 2021, advanced first substitute Senate Bill 161 (mental health systems amendments) in a roll-call vote that produced 25 yes, 0 no, and 4 absent. The measure requires the base budget to include certain appropriations to the Department of Health and Human Services for insurance plans that contract with Medicaid to provide behavioral health services, requires that health plans reimburse behavioral telemedicine at the contracted in-person rate, and forbids health plans from requiring a provider to use a particular technology method for delivering behavioral telemedicine.
Sponsor Senator Weiler told the Senate the measure is intended to protect rural access and preserve psychiatrist participation by preventing reimbursement at lower telemedicine rates that could discourage providers. "We've had some stakeholders that want to reimburse telemedicine at a lower rate than the in person rate," Weiler said, adding that if reimbursements are too low “we won't be able to get any psychiatrist to participate in the telemedicine program, which benefits rural Utah.”
Senator Winterton raised fiscal concerns on the floor, asking whether counties had been involved in stakeholder discussions and saying "it looks like it's about $267,000 per county to pick up this." Weiler responded that counties had been involved and that the body could increase the fiscal note to relieve county burdens, noting past practice where counties bear a proportional share of mental-health expenses.
Senator Davis supported the bill and emphasized that many recipients would be Medicaid-eligible, which can offset local costs through federal-state Medicaid matches. "When it comes to telehealth, it's not gonna cost the counties the dollars for the telehealth that would actually come out of the billable that is there currently," Davis said, arguing for the bill's potential to expand access without a commensurate county fiscal shock.
Weiler said negotiations with stakeholders were ongoing and that the sponsor's intent was to pass the first substitute and continue negotiations through the end of the session. The first substitute of SB 161 passed and will be sent to the House for consideration.
Actions recorded in the Senate proceedings showed the passage was by roll call with the clerk reporting 25 yay votes and 0 nay votes with 4 absent.
