A bill allowing the state Medicaid program to hire managed care companies to provide health coverage to the mentally ill and developmentally disabled cleared a House committee Thursday.
Sponsored by Rep. Aaron Pilkington, R-Clarksville, House Bill 1706 would implement a proposal by Gov. Asa Hutchinson aimed at reducing costs and better coordinating care for certain Medicaid recipients who have expensive needs.
Using the state's 2.5 percent tax on insurance premiums, the plan would also provide revenue that would be used to reduce the number of people with developmental disabilities who are on a waiting list for home-based services, such as providing help with daily living tasks.
Half of the money from the tax would be directed toward serving people on the list.
Dennis Smith, a senior adviser to Department of Human Services Director Cindy Gillespie, told the House Public Health, Welfare and Labor Committee that the companies would take over coverage for about 30,000 Medicaid recipients who have significant mental health needs or developmental disabilities.
The Medicaid program, which has a total budget this year of about $7.2 billion in state and federal funds, spends about $1 billion a year in medical care and other services for such recipients, Smith said.
The bill would require the managed care companies to be at least 51 percent owned by health care providers and to contract with providers across the state.
The Medicaid program would pay a fixed amount for each Medicaid recipient covered by the companies, with the federal government providing about 70 percent of those funds. The state would then recoup 2.5 percent of those payments through the premium tax.
The managed care plans would not cover residents of the state's nursing homes, assisted living facilities or human development centers. Those recipients would continue to be covered under the traditional, fee-for-service Medicaid program.
The state would begin enrolling the managed care companies in October, but the program wouldn't be fully implemented until 2019, Smith said.
Organizations serving the mentally ill, developmentally disabled and providing substance abuse treatment spoke in favor of the proposal Thursday.
Mark George, whose 17-year-old daughter has Down syndrome and has Medicaid coverage, said he's concerned that the managed care companies will have an incentive to move the highest-cost recipients into the human development centers.
Smith responded after the meeting: "We don't think that will happen."
"The department controls the front door to the HDCs, so somebody can't just go in on their own," Smith said.
A Section on 03/10/2017