State Commitment to Continue Paying 100% Cost-Based Reimbursement to Health Centers

Legislative

California: AB 715 introduced; Health and Welfare Secretary has indicated support of legislation.

Indiana: SB 259 introduced, approved by both House and Senate, and signed into law by governor.

Iowa: Legislation to statutorily require 100% cost-based reimbursement included in Department of Human Services budget, HF 760. Approved by House and Senate and signed by governor before May 31st deadline.

Maine: Legislature passed legislative language to codify payments at 100%

Maryland: SB 577 and HB 660 introduced and passed by both Houses. Governor signed HB 660 into law.

Minnesota: SF 130, HF 332 to pay 100% of cost introduced and voted out of committees; however, final version signed by governor revised to pay according to BBA levels for next two years (95% in FY 2000, 90% in FY 2001), but as an 1115 waiver state that eliminated cost-based payments, the action is a "win" for health centers.

Rhode Island: SB 0467 voted out of Senate Finance Committee; a hearing has been scheduled for H 5828 in House Finance Committee.

Tennessee: Alternative to cost-based reimbursement being formulated (1115 waiver state); primary care association trying to enforce terms and conditions of state’s waiver that require wrap-around payments to health centers.

Texas: Payment fix attached as amendment in House to sunset legislation authorizing Department of Health. This legislation (HB 2085) approved by Legislature and signed into law by governor.

West Virginia: Issue referred to interim committee for review by Senate Health Chair.

Administrative

Arkansas: Medicaid director included payments in budget request to governor. Legislature passed two-year budget with payments at 100%

Colorado: Fiscal year 2000 state budget (July 1, 1999 to June 30, 2000), which included payments at 100%, passed legislature and was signed by governor.

Idaho: Received verbal commitment from Medicaid director to keep payments at 100%. Finalized state budget for next two fiscal years includes payments at 100%.

Illinois: State would have to make an administrative rules change to lower payment rate; received verbal agreement from Medicaid director to keep payments at 100%.

Michigan: Created alternative payment mechanism approved by Medicaid director.

Missouri: Medicaid director included payments in budget request. Legislature finalized budget with payments at 100%.

Montana: State primary care association reports that no action has been taken to legislatively or administratively reduce level of payments to health centers; letter from governor states there are no plans to change current practice of payments at 100% and that such action would not occur without seeking public comment.

Nebraska: Legislature finalized budget with payments at 100%.

New Hampshire: Medicaid director included payments in budget request to governor. Governor’s budget includes payment rate at 133% of upper Medicare cap or at 100% of cost, whichever is least expensive. Governor’s budget is still in discussion in Legislature.

New Jersey: Finalized state budget includes payments at 100%.

New Mexico: Received verbal commitment from Medicaid director to keep payments at 100%.

Oklahoma: Medicaid agency has proposed amendment to 1115 waiver as alternative to cost-based reimbursement. Office of State Finance has not included proposal in budget. Amendment is pending HCFA approval.

South Carolina: Finalized state budget includes payments at 100%..

South Dakota: Medicaid director included payments in budget request to governor. Legislature finalized budget with payments at 100%.

Vermont: State committed to 100% cost-based reimbursement through 2002 in its 1115 waiver; has given verbal commitment to work with primary care association to extend payments beyond 2002.

Virginia: While state primary care association has not received any formal commitment to keep payments at 100%, no action has been taken to legislatively or administratively reduce level of payments to health centers.

Washington: Pre-existing state statue sets the rate at 100%; to reduce payments, the state would have to go through costly administrative rule-making procedures. Governor included payments at 100% in budget to Legislature.

Wisconsin: Governor included payments in budget. Budget will be finalized in July 1999.

Source: National Association of Community Health Centers, Inc., as of July 6, 1999.