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February 25, 2008 issue
Medicaid
BILL: HB 1266 – Eligibility Criteria for Medicaid Waiver
AUTHOR: Rep. Sheila Klinker, D-Lafayette
SPONSOR: Sen. Marvin Riegsecker, R-Goshen
ISMA POSITION: Neutral
THIS WEEK: No action. The bill awaits a House motion to concur with or dissent to changes made by the Senate.
The bill requires the Indiana Office of Medicaid Policy and Planning to seek an amendment to the developmental disabilities waiver to set priorities in providing services. The goal of the bill is to get needed services to those who are transitioning out of institutional care in order to secure a successful transition.
Bill: SB 42 – Select Joint Commission on Medicaid Oversight
AUTHOR: Sen. Patricia Miller, R-Indianapolis
SPONSOR: Rep. Charlie Brown, D-Gary
ISMA POSITION: Support
THIS WEEK: The bill was amended on the House floor and is now eligible for a vote by the full House. The amendment aimed to require the state budget agency, the fiscal arm of the administration, to disperse funds to Area Health Education Centers (AHEC) according to laws passed in previous years.
The original SB 42 repeals the expiration of the Select Joint Commission on Medicaid Oversight that was set for the end of 2008. This commission has been instrumental in monitoring Indiana’s Medicaid managed care program. The bill also adds authority to the commission to determine whether a Medicaid managed care organization has met the terms of its contract with the state.
The bill was amended in the Senate to also require Medicaid managed care organizations in the risk-based and behavioral health programs to be NCQA certified and to accept electronic claims filed by Medicaid providers.
BILL: SB 164 – Medicaid Claim Payments
AUTHOR: Sen. Patricia Miller, R-Indianapolis
SPONSOR: Rep. Charlie Brown, D-Gary
ISMA POSITION: Support
THIS WEEK: The House voted 83-6 in favor of the amended version of SB 164. The bill has been returned to the Senate where the author may concur with or dissent to changes made by the House.
Amendments to SB 164 included a requirement that Indiana Medicaid pay a Federally Qualified Health Center or Rural Health Clinic based on a prospective payment methodology if the Centers for Medicare & Medicaid Services (CMS) provides federal financial participation for such payment methodology.
The second amendment clarified that Indiana Medicaid has authorization extending eligibility up to the maximum amount approved by CMS provided that eligibility is below 300 percent of the Federal Poverty Level. The last amendment clarified eligibility for the new Healthy Indiana Plan (HIP) by allowing those above the HIP income threshold of 200 percent to buy into the program, without any state subsidization.
The bill continues to require a Medicaid managed care organization to abide by current insurance requirements regarding timely payment of claims.
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