Watched the Medicaid Oversight Advisory Board (MOAB) meeting today, and took these notes.
HB 689 – establishment of a Medicaid state-directed payment program
It looks like a lot of MDs and nonMD providers can’t get Medicaid reimbursement because they don’t work through a “qualified hospital provider.” Medicare has reduced by 7.5% the amount they pay out over the last 5-6 years that used to help cover salaries, malpractice insurance, etc. This program would allow those providers to have an agreement through “approved providers” like UK & UL so they could get reimbursed. No cost to KY general fund (apparently it would come thru the federal portion of the reimbursement). It won’t help everyone (if they’re not aligned with approved providers, like some of the small hospital systems). Apparently our Medicare & Medicaid reimbursement is already really low since KY is considered a “low wage” state. Meredith said federal HR1 disproportionately impacts KY/rural KY. Lisa Willner thinks it’s a great bill. No negative comments from the board.
HB 583 – School-based Medicaid programs
HB 583 would expand reimbursement for medical & mental health services being provided in schools for children covered under Medicaid. Emily Beauregard from Ky Voices for Health (she’s brilliant!) spoke & really understands the Medicaid stuff. The goal is to get one mental health practitioner per 250 kids. Schools can bill Medicaid for many of the students seen. Part of the bill would provide funding for training the schools on proper coding/billing, etc. Very positive response by board members.
HB 2 – omnibus Medicaid bill
Apparently they are making some changes to the Omnibus Medicaid bill due to pushback. I didn’t catch all of it, but it appears they are changing the hardship provision to align the unemployment rate with the federal standards. (This will particularly benefit counties in eastern Kentucky.) The original bill had a start date of 7/1/26; that’s been moved to the same as the Fed start date, 1/1/27. Dr. Schuster pushed back about the self-determination aspects/language because it will be too hard for folks to understand (especially if they have reading/communication difficulties). Also, Senator Meredith pushed back hard on the cost sharing: said it won’t be worth the trouble to try to set up collection systems. “Can’t get blood out of a turnip … poor people don’t have it.” Representative Ken Fleming countered that the co-pay was an attempt to get people to go to a primary care provider instead of the ER. Another issue that came up was the data collection and who’s going to “own it.”
SB 201 – Medicaid coverage for evaluation and management services
This bill would allow medicaid coverage for MDs/healthcare practitioners to bill for more than “1 problem” per patient visit. Currently they are supposed to make the patient return for another visit if they have more than one problem. The bill would allow a change in the medical billing coding. Got a lot of support from the board.
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