/Deadlock broken; Medicaid bill breezes to passage in both chambers

Deadlock broken; Medicaid bill breezes to passage in both chambers

Both sides eventually agreed to the legislation that outlines how the agency will spend $6 billion annually. However, Senate members declared themselves the winners of the two-month political battle after eliminating plans for a hospital run insurance program. House members wanted Mississippi True to have the chance to win a lucrative contract with Division of Medicaid. The insurers that were already contracted with Medicaid, however, resisted the idea. They pointed out that Mississippi True had failed to bid for a contract in June last year. The Senate joined the fight, saying that it would set a bad precedent for the Legislature to decide which companies should be awarded agency contracts. “Is it a victory because we have a tech law that doesn’t require a sole-source contract through Division of Medicaid?” It’s a win, said Senate Medicaid Chairman Brice WIggins, R.Pascagoula shortly after the lawmakers filed the amendments Monday night. House leadership has been struggling with the issue of the provider plan, an offshoot from the powerful Mississippi Hospital Association. Mississippi True was unable to win one of three multi-billion-dollar managed care contracts for Medicaid in June. The results of the bid were so controversial that the agency’s executive Director was forced to resign in December. The House proposed two options to help Mississippi True in an effort to correct this. One would have allowed the new company to manage a small percentage of managed care beneficiaries. Another would have required that the Division of Medicaid rebid its contracts. On Monday afternoon, several legislators spoke out in opposition to the speaker and said that they are open to attending a special legislative session to discuss the issue. The bill would have been killed if the Senate and House had not reached an agreement by Monday night at 8 p.m. The governor would then have the power to call a special session or run the agency through executive order. Rep. Tom Miles (D-Forest) stated that hospitals are vital to rural communities when you come from one. “We don’t have to rush for a decision,” said Rep. Tom Miles, D-Forest. But those who thought that House members would fight hard when the bill reached the chamber’s floor Tuesday afternoon were disappointed. The House debate took just over 40 minutes. This was almost 15 minutes less than the Senate’s morning floor debate. With six votes in favor, the House passed the bill with a greater margin than the Senate. The Senate had eight. Although the provider-run plan was a sticking point during negotiations, the Senate’s strong position on the issue wasn’t a deal-breaker for House members. They acknowledged that the Senate’s victory on this issue made it possible to support several other House programs, including allowing Medicaid to pay for drug addiction treatment, and increasing Medicaid payments to hospitals. Rep. Jason White (R-West), who was responsible for leading the House’s tech bill negotiations, said, “That’s where it was on it.” “I felt it was vitally important we had a tech bill. While I understand the argument for a provider sponsored plan — and I get it, I want our hospital to thrive — this bill allows legislative input. Wiggins and White referred to the Medicaid tech bill as a “budget neutral” bill. While the sum of the proposed changes in the bill didn’t cost the agency more, they were not going to make the agency any money. It’s unclear if it is “chamber neutral”, meaning that the bill incorporates equal parts from the Senate and House plans. This depends on the person answering the question. The Senate won big right away, not only by eliminating provider-run language in the health plans, but also by including recommendations of the Medical Care Advisory Committee with which Wiggins had been closely involved over the past year. These included the lifting of prescription drug and primary care visits caps and allowing Medicaid to cover 17-P, a highly effective but expensive medicine that delays preterm babies. Wiggins stated that it was a good piece of legislation that promotes Medicaid in the state and improves outcomes. It also addresses accountability. Not all Senate wins were House defeats. House support also included lifting prescription caps and primary care visits, and the use 17-P. While hospitals are still out of managed care, the final Medicaid tech bill did include plans that would help hospitals. The bill requires that the long-criticized hospital reimbursement formula be reworked by the agency. It also includes a provision that allows certain rural hospitals to be paid at the higher Medicare rates through Medicaid. Sam Mims (R-McComb), House Public Health Chairman, said, “I think it is actually one of the most important things we can do to our small, rural hospitals.” He has sponsored similar bills for rural hospitals for many sessions, but none of them have made it to the House floor. Another provision in the House, the Medicaid technical bill, also contains an amendment that allows Medicaid payment for drug addiction treatment. It also contains House language mandating Medicaid to independently audit its managed-care companies in order to save the state money. Wiggins stated that the Hospital Association made it about one issue, even though it wasn’t a single-issue bill. The House leadership may have had more leverage if they held on to the provider-run plan until the last minute. Several House members said that they were still too optimistic even after negotiations had ended. It’s not always acceptable, but it’s all that’s on the table. It’s all that we have,” said Rep. Bryant Clark (D-Pickens). The House considered the proposal and voted to lift it on Wednesday.