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|
SPONSOR: |
Lujan |
DATE TYPED: |
01/31/02 |
HB |
269 |
||
|
SHORT TITLE: |
Medicaid Services Reimbursements |
SB |
|
||||
|
|
ANALYST: |
Dunbar |
|||||
APPROPRIATION
|
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or Non-Rec |
Fund Affected |
||
|
FY02 |
FY03 |
FY02 |
FY04 |
|
|
|
|
|
|
$2,600.0 |
Recurring |
General Fund |
|
|
|
|
$7,800.0 |
Recurring |
Medicaid Federal Funds |
(Parenthesis
( ) Indicate Expenditure Decreases)
Relates
to SB 241 and SB 9
Human Services Department (HSD)
SUMMARY
Synopsis
of Bill
House Bill 269 amends a section of the NMSA 1978
to allow the Human Services Department to set the reimbursement rates for
services rendered by physicians, dentists, optometrists, podiatrists and
psychologists to Medicaid patients at not less than 95% of the corresponding
rates reimbursable under Part B of Title 18 of the federal Social Security Act. The bill also amends the exclusions of
Managed Care Organizations from the reimbursement rate. The effective date of implementation is
July, 1,2004.
Significant
Issues
The reimbursement rate will be pegged to Part B
of Title 18 of the federal Social Security Act and may need to be adjusted on a
yearly basis effective July 1 2004.
HSD, reports
that Medicaid’s ability to control managed care costs would be significantly
weakened because HB 269 would affect Medicaid’s capacity to negotiate contracts
with providers MCOs. HSD further states
that existing market conditions in the New Mexico healthcare industry presently
force MCOs to maintain fairly comparable reimbursement rates to the rate
Medicaid pays fee-for-service providers and programs.
FISCAL IMPLICATIONS
Although
there is no appropriation in HB 269, the projected appropriation needed from
the General Fund would be increased by a minimum of $2.6 million. Federal fiscal year 2004 revenues from the
federal Medicaid program would be increased by a minimum of $7.800.0. HSD indicates that HB 269 would increase
costs to Medicaid automatically every year and could adversely affect cost
containing efforts in the Medicaid program.
Medicaid expenditures for physician services in state fiscal year 2003
are estimated to be at $196 million.
Dental service expenditures on the fee-for-service side are estimated to
be at $10.3 million in state fiscal year 2003.
Medicare rate increases or decreases for healthcare professionals since
2000 are unknown.
ADMINISTRATIVE IMPLICATIONS
Recalculating reimbursement rates annually would add an administrative function to the Medical Assistance Division, Benefit Services Bureau (fee for service programs) and for the MCOs.
RELATIONSHIP
HB
269 is a companion to SB 241. SB 241
differs only in that the rates would be set at the beginning of each state
fiscal year. HB 269 relates to SB
9 which would appropriate $4,000.0 to
increase Medicaid physician payments to 100% of the Medicare rate, beginning
July 1, 2002.
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