House committee advances substitute for HB 70 to fund EHR, expand MAT and implement justice‑involved Medicaid billing

Representative Eliason introduced the first substitute to HB 70 and told the Health and Human Services Committee the measure fills critical gaps needed to implement a justice‑involved Medicaid demonstration waiver that allows billing Medicaid for inmate health services up to 90 days before release.

"If we don't put the landing gear down, which is the kind of the EHR, it's not gonna even happen," Representative Eliason said, urging passage of tools needed to bill Medicaid and realize projected savings.

The substitute would allow one‑time funding from the Medicaid growth production and budget stabilization account to purchase an electronic health record (EHR) with billing functionality. Dr. Mark Wisner, director of Correctional Health Services, testified the current EHR lacks a billing module and coding system and is the largest obstacle to billing Medicaid. "Right now we have about 6,500 inmates. About 3,500 of those come in with a diagnosis of a substance use disorder," Wisner said, explaining how an EHR would support care continuity and billing.

Sponsor and staff said the waiver—already approved by the Legislature and by CMS—permits billing for services in the 90 days before release, an exception to the general rule barring Medicaid billing in carceral settings. The bill also includes a provision to allow previously appropriated funds for correctional health emergency expenses to be non‑lapsing so the department can smooth unanticipated high costs.

A second major component narrows an earlier proposal for opioid use disorder treatment so the department, in consultation with the Department of Corrections, will focus treatment efforts on two groups: people in intake units during their first 90 days and those in the 90 days prior to release. The plan includes medication‑assisted treatment (MAT), counseling, and reentry coordination so released individuals can continue care in the community.

Representative Ward asked whether inmates would remain on MAT for long sentences or be weaned. Dr. Wisner responded that many people enter correctional systems already enrolled in MOUD programs at county jails and that treatment plans are individualized. "What we're looking forward to doing is continuing that," he said, and emphasized the focus on pre‑release handoff and tracking outcomes.

The bill includes a $500,000 one‑time appropriation from the general fund in the operating capital budget to purchase a pilot AI program that monitors inmate‑to‑outside communications and flags phrases for human review. Sponsor said the tool has been used in pilots to detect mental‑health issues and prevent suicide; committee members raised questions about vendor selection and safeguards. Representative Eliason said there would be no direct inmate‑AI interaction and that flagged calls would be reviewed by staff.

On fiscal questions, the sponsor said the published substitute did not yet carry a new fiscal note but expected the primary one‑time cost would be the $500,000 AI appropriation plus the one‑time EHR procurement; ongoing maintenance costs should be offset by Medicaid billing savings. Exact EHR procurement costs were not specified in committee testimony.

Representative Monson moved the first substitute and then moved that the committee recommend HB 70 favorably. Both motions passed on voice votes with no recorded opposition.

The committee's favorable recommendation sends the substitute to the next stage of the legislative process; the sponsor said the change is intended to close implementation gaps so the previously approved waiver can operate as intended.