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Lawmakers defer personal‑care Medicaid rate after differing actuarial analyses
Summary
DHS recommended a 1.4% increase in Medicaid personal‑care rates; legislators and a consulting economist said that understates costs given minimum‑wage changes. The committee voted to defer further action for follow‑up and additional data.
Mark White of the Department of Human Services presented a rate‑review process that led DHS to propose a 1.4% increase in personal‑care Medicaid reimbursement, saying the department used cost surveys and actuarial review to arrive at the recommendation and will revisit the rate in the fall.
Representatives on the committee—including Representative Miller and Representative Bentley—said the proposed increase is too small to absorb rising labor costs, particularly a scheduled raise in minimum wage. ‘‘That doesn’t near about make up the difference in…what’s being required by the minimum wage increase,’’ Representative Miller said during discussion.
Independent economist Jim Metzger, who said he was asked to review the Milliman analysis, told the committee he found Milliman understated median wages and overhead. Metzger presented a model that produced a higher per‑15‑minute rate (he said a 15‑minute rate equivalent to roughly $19.31 per hour), arguing DHS’s assumptions should be revisited. ‘‘We determine that that rate should be a final rate of $4.83 as opposed to the $4.50,’’ Metzger said in his presentation of alternative calculations.
Providers represented by Matt McClure of the Home Care Association said they have been meeting with DHS and requested more time and data to reconcile differing cost surveys. DHS said it had asked for providers’ recent cost surveys but had not received all underlying data needed to compare methodologies.
After extended discussion and public testimony, Representative Miller moved to defer consideration and asked DHS to return with revised or supplemental analysis; the motion to defer carried on a voice vote. Committee staff and members asked DHS to circulate the Milliman report and the independent analysis to committee members for review ahead of the follow‑up meeting.
The committee’s action leaves the emergency 1.4% adjustment in place for now but directs DHS to return with additional work for the committee to vet before a final, longer‑term adjustment is adopted.
