DIVA asks Legislature for $39.2M BAA to cover Medicaid costs, IT maintenance and provider payments
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Summary
DIVA leadership told the House Appropriations Committee it needs roughly $39.2 million across funds — driven by higher Medicaid cost‑per‑case, the Medicaid data warehouse’s move to maintenance, and one‑time IT and provider payments — and supplied line‑item detail to be provided later.
DIVA Commissioner Deshaun Rose and agency staff briefed the House Appropriations Committee on a budget adjustment bill (BAA) that would add about $39.2 million across funds to align the agency’s budget with recent program experience and new operational costs.
The request covers a $33 million programmatic consensus update linked to higher cost‑per‑case Medicaid claims, administrative adjustments including ongoing maintenance for the Medicaid data warehouse and analytics solution (MDWAS/MDWise), and several onetime items such as a required HealthConnect cloud migration.
Why it matters: agency staff said caseloads have declined but remaining enrollees have higher acuity and per‑case costs than projected, creating a significant midyear funding gap. The agency also said a development‑phase Medicaid data warehouse has gone live and will enter a maintenance and operations phase in January, creating an ongoing spending need that was funded initially with onetime dollars.
Key details: staff identified a modest $39,400 contract increase for physicians who support the chief medical officer and described Gainwell contract amendments for interoperability work. The MDWAS transition to maintenance was presented as a partial‑year addition, discussed in the slides as roughly $2.3 million total with about $1.4 million from the general fund for the partial year; staff said they will provide a full historical spending spreadsheet on the project. Commissioner Rose described the data warehouse as a “data lake,” saying it will “pull in all the Medicaid resources that we have and other data sources as well” to automate reporting and free staff to conduct deeper analysis.
Programmatic drivers: the consensus update was framed as a catch‑up to recent claims experience; staff said the adjustment responds in part to pharmacy utilization and related federal Part D 'clawback' calculations. Staff identified a clawback change of about $1 million and buy‑in adjustments of roughly $2 million as components of the overall increase.
Onetime and transition items: the BAA includes a $2,720,000 onetime request to migrate HealthConnect to the cloud for security and federal compliance, a reconciliation payment that may change to the Brattleboro Retreat contract for excess bed days, and transition funds previously appropriated that are being distributed (the agency said $10.8 million was allocated for transition payments split roughly $5.1 million for SASH and $5.7 million for Medicare Blueprint bridge payments). Staff also reported $10 million originally appropriated last year for provider stabilization with about $3.3 million remaining and that current outstanding applications exceed the balance.
Funding totals and next steps: staff summarized the request as about $4.9 million general fund and $29.7 million in Global Commitment funds (roughly $39.2 million total, including federal match). Staff said additional granular ups/downs by line item will be provided to the committee and that several detailed follow‑up items (including provider counts for ABA services and the historical MDWAS spend) will be supplied in a subsequent briefing.
The committee did not take votes during the briefing; staff were asked to provide supplemental detail on MDWAS spending, the granular drivers of the $33 million consensus update, and the onetime reconciliation numbers. The briefing closed with thanks to agency staff for coming on short notice.
