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JBC chair: Medicaid caseload, provider-rate cuts drive majority of supplemental request
Summary
Rep. Taggart told the caucus the HCFA supplemental request is about $134 million, driven by a nearly $222 million medical caseload forecast. He warned provider-rate reductions (including some codes at 85% of Medicare) could push providers below cost.
Rep. Rick Taggart told the House minority caucus the Health Care Policy & Financing (HCFA) portion of the supplemental is the largest single driver of the package, with a total request of roughly $134 million and a medical-forecast caseload driver approaching $222 million. He said the state's Medicaid costs are on an "unsustainable path" and that the supplemental includes provider-rate reductions that concern him.
Taggart highlighted two portfolio-level reductions: the executive order that removed a previously approved 1.6 percent provider increase (a change he said reduced total funds by about $108 million and general fund by about $38 million), and a proposal to reimburse certain procedure codes at 85 percent of the Medicare benchmark. He said the 85 percent figure represents a move below cost for many clinics, hospitals and providers and will heighten pressure on margins.
Members asked for more detail; Taggart said some of the variation depends on whether a procedure has an associated Medicare code. He cited anesthesiology as an example: anesthesiologist reimbursement has moved from more than 140 percent of Medicare historically to 100 percent and is now proposed by the department to move to 95 percent for some codes, a change testifiers described as alarming.
The caucus also discussed a separate HCFA line item for children and pregnant women lacking access due to immigration status (referred to in the briefing as ~ $53 million for the current year and projected to grow to about $60 million next year). Taggart said Denver Health constitutes a significant portion of that cost and acknowledged the fiscal note seriously underestimated the current-year need.
Taggart said JBC staff will seek more detailed coding and provider lists for members who asked, and urged the caucus to look first for internal department savings before imposing cuts that would directly affect consumers and providers.
