Medicaid bill still in hearings as session nears the end.

Thursday, May 3, 2007 | 12:00 a.m. CDT; updated 7:31 a.m. CDT, Thursday, July 17, 2008

JEFFERSON CITY — With two weeks left in the 2007 General Assembly session, a committee vote on the bill to restructure Medicaid has been delayed until Tuesday at the earliest, committee chairman Rep. Robert Schaaf, R-St. Joseph, said during a hearing Wednesday.

Senate Majority Floor Leader Charlie Shields, R-St.Joseph, said the committee’s delay will make the bill a close call to pass this legislative session.

“The faster he (Schaaf) can get it into conference the better off we are,” he said. “At this point it looks like its going to be the last week before he can get it into conference. I think we can get it done. It would be helpful if they could move it along a little faster.”

Shields, the sponsor of original bill, testified at the hearing about the extensive changes Schaaf’s newest draft would make. Shields’ version passed the Senate on April 11. Schaaf’s substitute draft was submitted Monday as a result of criticisms Shields’ bill received in a committee hearing last week.

Schaaf’s substitute would increase reimbursement rates for physicians. Schaaf said this is an attempt to increase the number of providers in the program as well as access to care to HealthNet recipients.

“Clearly that is an issue that needs to be addressed. I think we’ve said on the Senate side, even though it wasn’t in our version, that it does you no good to have a benefit card and nowhere to use your benefits,” Shields said.

Schaaf’s draft would completely eliminate the Senate bill’s preference for federally qualified health centers. Instead, it would require the centers to contract with willing providers before hiring their own physicians.

Susan Wilson, CEO of Northwest Health Services, a federally qualified health center in northwest Missouri, testified that such a requirement would violate the federal requirements to maintain their status.

“If we decide to contract for services, we have to prove to our federal granting agency that that really is the best way to go rather than direct employment,” Wilson said.

Shields testified that he was concerned about that provision as well, saying the centers are a primary care access point funded and recognized by the federal government. After the hearing, Shields explained his concerns.

“FQHCs are the safety net for not only the Medicaid population but also for people without insurance, and we think it’s appropriate to support them and give them a preference,” he said.

The draft would expand some eligibility for disabled workers, add dental coverage, offer a different version of the women’s health program that was in the Senate’s bill, and partially reinstate the ticket-to-work program, which allows people with disabilities to work and still maintain their Medicaid coverage.

Shields testified about these expansions, saying that he suspects that the costs are getting “pretty high.” He later said that he thought these expansions would likely lead to budget problems.

“Eligibility, certainly, is going to be a part of it. He’s expanding services,” he said. “We just don’t know at this point what the size of the fiscal note will be.”

If the committee passes the bill Tuesday, at the earliest it would be Thursday of next week before debate could begin on the House floor, Schaaf said.

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