The House on Wednesday voted unanimously not to concur with the Senate Medicaid reform plan passed in that chamber last week.
House Bill 372 first cleared the House in June as a six-page bill but grew to a nearly 30-page document while in the Senate.
Now leaders in both chambers will name members of a conference committee to try to negotiate a compromise bill.
With budget negotiations in full swing, and an Aug. 31 deadline hanging over the legislators, political observers agree adding Medicaid reform to the pile is a tall order.
Legislators from both chambers have committed to putting Medicaid reform to bed this session after years of negotiations on the issue.
At the heart of both chambers’ plans is pushing the financial risk off of the state and onto the providers, whether that be through managed care organizations (MCO), including insurers and provider-led entities (PLE), as in the Senate plan, or an approach that relies more on just PLEs, which the House is pushing.
The Senate plan provides for the formation of a new Department of Medicaid
(DOM), while the House plan keeps Medicaid under the Department of Health and Human Services (DHHS) and has DHHS reporting to the federal Centers for Medicare and Medicaid Services (CMS).
Under the Senate plan the DOM would deal with CMS.
The Senate plan calls for the formation of a Joint Legislative Oversight Committee on Medicaid.The idea behind putting the risk on PLEs and MCOs is that the state will pay a flat fee for each patient instead of for each procedure, building in more budget predictability and incentivizing preventative care from providers.
Under the Senate bill, the state would contract with up to three MCOs to provide coverage across the state. Health care professionals would be invited to form companies to serve as provider and insurer.
The bill passed in the Senate 34-10 on third reading.
The Senate plan would go into effect next year while the House plan would go into effect immediately following the appropriation of $2.5 million by the General Assembly.