With minutes to spare, Medicaid tech bill lives

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The controversial Medicaid technical bill lives to see another day.

After a tense weekend that saw both Senate and House leaders threatening to kill the massive bill, which lays out the rules for the Division of Medicaid and its $6 billion budget, lawmakers signed off on a final version just four minutes before Monday’s 8 p.m. deadline. The House and the Senate vote on the bill Tuesday.

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Sen. Brice Wiggins, R-Pascagoula

“We weren’t willing to move on (from the issue),” said Senate Medicaid Chairman Brice Wiggins, R-Pascagoula. “I think it represents a good piece of policy, and I look forward to presenting it (to the Senate).”

Whether Senate and House members agree on the Medicaid tech bill will have to wait until Tuesday morning, when each body votes on the conference draft of the bill.

The conference bill makes substantial changes from the previous version, which the House had passed earlier this month. It includes provisions that allow the agency to reimburse providers for the treatment of people addicted to opioids, but does not provide for the treatment of other drug addictions. It also includes language increasing the reimbursement rate for Mississippi’s rural hospitals, many of which have struggled financially in recent years and other language that mandates that the division redo its overall hospital reimbursement formula.

What it doesn’t include is the most controversial part of the House platform, an allowance for a hospital-run insurance program within the Division of Medicaid. The idea of a provider-sponsored plan has had strong support among House members in both parties. Earlier versions of the House Medicaid bills that included this language had passed by large margins.

That same measure, however, had never gained traction within the Senate. And as the deadline approached and the stalemate between the two houses continued, lawmakers admitted there was a strong possibility of the tech bill dying. Ultimately, the House caved to the Senate position.

When asked, Speaker Philip Gunn, R-Clinton, downplayed the importance of including a provider-sponsored plan.

Speaker of the Mississippi House Philip Gunn

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Speaker Philip Gunn, R-Clinton

“We obviously were just trying to run the most effective (Medicaid) program that we can,” Gunn said. “That was one idea. We thought we could build more competition with the provider-sponsored plan. Obviously that is something that we think results in a better bill. But that was a sticking point. And getting the deal done was more important, I guess.”

For the past two months the House has largely aligned itself with the hospitals, passing versions of a tech bill that would make room in the managed care program for Mississippi True, a new provider-run insurance company that has the backing of the Hospital Association. Last summer, Mississippi True vied for and lost out on one of the three lucrative managed care contracts given by the Division of Medicaid. Several lawmakers believe it deserves another shot.

But the three Medicaid insurers who received those contracts in June — Magnolia Health, United Healthcare and Molina Healthcare — have pushed back, arguing that it sets a bad precedent for lawmakers to involve themselves in internal agency business just because they don’t like an outcome. The Senate has largely sided with the insurers, passing versions of a tech bill that make no mention of a provider-run health insurance plan.

After a long recess on Monday night, the House voted 113-1 to approve the Medicaid appropriations bill that the Senate had passed that morning, though they held it on a motion to reconsider on Tuesday, providing time for them to wait until the Senate votes on passing the conference version of the Medicaid technical bill.