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March 3, 2008 issue
Medicaid
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 approved by the House and returned to the Senate for final consideration. Once received by the Senate, a dissent to the changes made by the House was filed, which sends this bill to conference committee.
The amendment made by the House aims 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 regarding such expenditures for AHECs.
The original SB 42 repeals the expiration of the Select Joint Commission on Medicaid Oversight 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 terms of its contract with the state.
SB 42 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: After receiving the bill back from the House, Sen. Miller, filed a dissent to the changes made in the House. A conference committee has already been appointed and will meet in the coming weeks to hammer out the differences between the two versions.
The House amendments to the bill include 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 clarifies that Indiana Medicaid has authorization to extend eligibility up to the maximum amount approved by CMS provided that eligibility is below 300 percent of the federal poverty level. The last amendment clarifies eligibility for the new Healthy Indiana Plan (HIP) allowing those above the HIP income threshold of 200 percent to be able to buy into the HIP, but 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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