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HB22-1268

Medicaid Mental Health Reimbursement Rates Report

Concerning a reporting of medicaid reimbursement rates paid to mental health providers.
Session:
2022 Regular Session
Subject:
Health Care & Health Insurance
Bill Summary

The bill requires the department of health care policy and financing (department) to prepare a behavioral health rates report of medicaid reimbursement rates for community mental health providers and independent mental health and substance use treatment providers. The department must hire an independent auditor to prepare the behavioral health rates report. and provide recommendations on the report to be presented to the house of representatives public and behavioral health and human services committee. The department is required , in coordination with the behavioral health rates report, to prepare recommendations based on the audit findings and recommendations to create equitable payment models between providers of community mental health centers and independent mental health and substance use treatment providers providing comparable behavioral health services. The department is required to present the behavioral health rates report and recommendations to the house of representatives public and behavioral health and human services committee.

The audit conducted must reflect data from state fiscal year 2020-21 and include a determination and recommendations on the adequacy of reimbursement rates paid to medicaid mental health providers. The department must present an action plan to implement changes to reimbursement rates based on the findings of the audit to the joint budget committee before November 15, 2022. The department must also prepare an annual progress report on the state's progress in implementing the action plan and provide an update at the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing annually through on or before August 1, 2023, and annually thereafter through August 1, 2025. The bill requires the department to fully implement the action plan no later than December 31, 2025.

The bill requires the department to publish an annual cost report on or before March 15 of each year March 15, 2023, and each year thereafter . The department must establish a cost report template and cost reporting schedule to assist providers community mental health centers in relaying cost information to the state department. The bill requires the department to establish a transparency report that translates the cost report data into meaningful and actionable information to ensure equity in provider compensation and adequate access to care for medicaid members. The department is required to redact certain information from the cost reports to ensure compliance with state and federal privacy laws. The bill requires the department to create a publicly accessible website providing information on the behavioral health rates reports and information to assist the public, medicaid providers, and medicaid members in understanding the published information.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)


(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Status

Introduced
Passed
Became Law

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