Print Friendly HOUSE BILL NO. 797 – Approp, H&W, Medical Assistance
HOUSE BILL NO. 797
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H0797.....................................................by APPROPRIATIONS
APPROPRIATIONS - DEPARTMENT OF HEALTH AND WELFARE - MEDICAL ASSISTANCE
SERVICES - Appropriates $607,010,000 to the Department of Health and
Welfare for Medical Assistance Services for fiscal year 2001; authorizes
the State Controller to make transfers to the Cooperative Welfare Fund;
reappropriates unexpended and unencumbered fund balances of the Cooperative
Welfare Fund for nonrecurring expenditures; authorizes expenditure of all
receipts collected as noncognizable funds; provides intent regarding the
Children's Health Insurance Program and encourages the Department of Health
and Welfare to implement the recommendations of the Children's Health
Insurance Program Task Force; provides intent regarding state veterans
homes; provides intent regarding transportation services to clients of the
state's Medicaid Program; provides intent regarding private intermediate
care facilities for the mentally retarded; provides intent regarding use of
generic drugs; provides intent regarding developmental disability agency
services; provides intent regarding rates paid for durable medical
equipment; provides intent regarding physical therapy; provides intent
regarding targeted case management services; provides intent regarding
mental health services; provides intent regarding cost-sharing by Medicaid
clients; provides intent regarding day treatment services to clients with
mental illness; provides intent regarding research into the feasibility of
reducing Medicaid service coverage; provides intent regarding a review of
the administrative costs of the Medicaid Program; provides intent regarding
the Department of Health and Welfare managing outside organizations with
whom the department contracts for services; and directs the Department of
Health and Welfare to take certain actions to implement Medicaid cost
control measures.
03/30 House intro - 1st rdg - to printing
03/31 Rpt prt - to 2nd rdg
Rls susp - PASSED - 36-31-3
AYES -- Bell, Black, Bruneel, Callister, Campbell, Cheirrett, Clark,
Crow, Cuddy, Deal, Denney, Ellsworth, Field(13), Gagner, Geddes,
Gould, Hadley, Hammond, Hansen(23), Hansen(29), Jones(Jones),
Kempton, Kendell, Kunz, Linford, Meyer, Montgomery, Mortensen, Moss,
Pischner, Pomeroy, Reynolds, Ridinger, Smith, Stevenson, Wheeler
NAYS -- Alltus, Barrett, Bieter, Boe, Chase, Field(20), Henbest,
Hornbeck, Jaquet, Judd, Kellogg, Lake, Mader, Marley, McKague, Moyle,
Pearce, Ringo, Robison, Sali, Schaefer, Sellman, Shepherd, Smylie,
Stoicheff, Stone, Taylor, Tilman, Trail, Wood, Zimmermann
Absent and excused -- Barraclough, Loertscher, Mr Speaker
Floor Sponsor - Hansen(23)
Title apvd - to Senate
04/03 Senate intro - 1st rdg - to Fin
Rpt out - to 2nd rdg
04/04 2nd rdg - to 3rd rdg
04/05 3rd rdg - PASSED - 27-7-1
AYES--Andreason, Bunderson, Burtenshaw, Cameron, Danielson,
Darrington, Davis, Deide, Dunklin, Geddes, Ingram, Ipsen, Keough,
Lee, McLaughlin, Noh, Parry, Richardson, Riggs, Risch, Sandy,
Sorensen, Stegner, Stennett, Thorne, Wheeler, Williams
NAYS--Boatright, Frasure, Hawkins, King-Barrutia, Schroeder, Walton,
Whitworth
Absent and excused--Crow
Floor Sponsor - Lee
Title apvd - to House
To enrol - rpt enrol - Sp signed - Pres signed
04/06 To Governor
04/14 Governor signed
Session Law Chapter 409
Effective: 07/01/00
H0797
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-fifth Legislature Second Regular Session - 2000
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 797
BY APPROPRIATIONS COMMITTEE
1 AN ACT
2 APPROPRIATING MONEYS TO THE DEPARTMENT OF HEALTH AND WELFARE FOR MEDICAL
3 ASSISTANCE SERVICES FOR FISCAL YEAR 2001; PROVIDING THAT THE STATE CON-
4 TROLLER SHALL MAKE TRANSFERS FROM THE GENERAL FUND; REAPPROPRIATING CER-
5 TAIN UNEXPENDED AND UNENCUMBERED BALANCES OF MONEYS; AUTHORIZING THE
6 EXPENDITURE OF ALL RECEIPTS COLLECTED; EXPRESSING LEGISLATIVE INTENT WITH
7 REGARD TO THE CHILDREN'S HEALTH INSURANCE PROGRAM; EXPRESSING LEGISLATIVE
8 INTENT WITH REGARD TO THE CHILDREN'S HEALTH INSURANCE PROGRAM TASK FORCE
9 RECOMMENDATIONS; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO MAKING STATE
10 VETERANS HOMES MEDICAID ELIGIBLE; EXPRESSING LEGISLATIVE INTENT WITH
11 REGARD TO CAPPING TRANSPORTATION EXPENDITURES AT FISCAL YEAR 2000 LEVELS;
12 EXPRESSING LEGISLATIVE INTENT WITH REGARD TO CAPPING THE NUMBER OF BEDS IN
13 MEDICAID FUNDED PRIVATE INTERMEDIATE CARE FACILITIES FOR THE MENTALLY
14 RETARDED; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO CAPPING RATES FOR
15 INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED AT FISCAL YEAR 2000
16 LEVELS; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO GENERIC DRUGS AND
17 DIRECTING THE DEPARTMENT TO RESEARCH THE FEASIBILITY OF IMPLEMENTING A
18 CLOSED MEDICAID DRUG FORMULARY; EXPRESSING LEGISLATIVE INTENT WITH REGARD
19 TO DEVELOPMENTAL DISABILITY AGENCY SERVICES; EXPRESSING LEGISLATIVE INTENT
20 WITH REGARD TO CAPPING RATES FOR DURABLE MEDICAL EQUIPMENT AT FISCAL YEAR
21 2000 LEVELS; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO PHYSICAL THERAPY
22 SERVICES; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO TARGETED CASE MAN-
23 AGEMENT SERVICES; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO MENTAL
24 HEALTH SERVICES; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO COPAYMENTS
25 AND OTHER COST-SHARING METHODS; EXPRESSING LEGISLATIVE INTENT WITH REGARD
26 TO DAY TREATMENT SERVICES PROVIDED TO CLIENTS WITH MENTAL ILLNESS;
27 EXPRESSING LEGISLATIVE INTENT WITH REGARD TO RESEARCHING THE FEASIBILITY
28 OF REDUCING MEDICAID SERVICE COVERAGE TO MORE CLOSELY MATCH PRIVATE INSUR-
29 ANCE COVERAGE; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO ADMINISTRATIVE
30 COSTS; EXPRESSING LEGISLATIVE INTENT WITH REGARD TO DEPARTMENTAL CON-
31 TRACTS; AND DIRECTING THE DEPARTMENT OF HEALTH AND WELFARE TO PROMULGATE
32 RULES AND DRAFT LEGISLATION.
33 Be It Enacted by the Legislature of the State of Idaho:
34 SECTION 1. There is hereby appropriated to the Department of Health and
35 Welfare for Medical Assistance Services the following amounts to be expended
36 according to the designated expense classes from the various funds listed for
37 the period July 1, 2000, through June 30, 2001:
38 FOR
39 FOR FOR FOR TRUSTEE AND
40 PERSONNEL OPERATING CAPITAL BENEFIT
41 COSTS EXPENDITURES OUTLAY PAYMENTS TOTAL
42 MEDICAL ASSISTANCE SERVICES:
43 FROM:
44 General Fund $ 4,560,900 $ 3,151,500 $ 51,000 $164,124,900 $171,888,300
2
1 FOR
2 FOR FOR FOR TRUSTEE AND
3 PERSONNEL OPERATING CAPITAL BENEFIT
4 COSTS EXPENDITURES OUTLAY PAYMENTS TOTAL
5 Medical Assistance
6 Fund 2,500 2,500
7 Liquor Control
8 Fund 650,000 650,000
9 Cooperative Welfare
10 Fund
11 (Federal) 6,565,200 10,932,100 61,000 394,710,300 412,268,600
12 Cooperative Welfare
13 Fund
14 (Dedicated) 22,200,600 22,200,600
15 TOTAL $11,126,100 $14,083,600 $112,000 $581,688,300 $607,010,000
16 SECTION 2. As appropriated, the State Controller shall make transfers of
17 the General Fund to the Cooperative Welfare Fund, periodically, as requested
18 by the Director of the Department of Health and Welfare and approved by the
19 Board of Examiners.
20 SECTION 3. There is hereby reappropriated to the Department of Health and
21 Welfare for Medical Assistance Services any unexpended and unencumbered bal-
22 ances of the Cooperative Welfare Fund as appropriated for Medical Assistance
23 Services for fiscal year 2000, to be used for nonrecurring expenditures only
24 for the period July 1, 2000, through June 30, 2001. The reappropriation shall
25 be computed by the Department of Health and Welfare from available moneys.
26 SECTION 4. Notwithstanding the provisions of Section 67-3516(2), Idaho
27 Code, the Department of Health and Welfare for Medical Assistance Services is
28 hereby authorized to expend all receipts collected in Medical Assistance Ser-
29 vices as noncognizable funds for the period July 1, 2000, through June 30,
30 2001.
31 SECTION 5. It is the intent of the Idaho Legislature that the federal
32 Title XXI Children's Health Insurance Program shall not exceed one hundred
33 fifty percent (150%) of the federal poverty level when determining eligibility
34 without prior legislative approval.
35 SECTION 6. The Idaho Legislature recognizes the work of the Children's
36 Health Insurance Program Task Force appointed by the director of the Depart-
37 ment of Health and Welfare. The department is encouraged to implement the rec-
38 ommendations of the task force to the extent legally possible and to apply for
39 the necessary federal waivers where required in order to provide basic health
40 care coverage for Idaho's uninsured children.
41 SECTION 7. It is the intent of the Idaho Legislature that the Division of
42 Veterans Services and the Department of Health and Welfare take the steps nec-
43 essary to make state veterans homes providers of services under the state's
44 Medicaid Program on or before February 1, 2001. It is further the intent of
45 the Idaho Legislature that for the period July 1, 2000, through June 30, 2001,
46 the cost limits described in Section 56-102(7) and Section 56-102(11), Idaho
47 Code, shall not apply to state homes for veterans. In addition, the Department
48 of Health and Welfare is directed to provide a status report on making this
49 conversion to the Joint Finance-Appropriations Committee at each of their reg-
3
1 ularly scheduled interim committee meetings.
2 SECTION 8. It is the intent of the Idaho Legislature that the total
3 expenditure for transportation services provided to clients of the state's
4 Medicaid Program for the period July 1, 2000, through June 30, 2001, shall not
5 exceed the amount spent in state fiscal year 2000. The department shall con-
6 sult with providers and advocates of persons receiving transportation services
7 on how to achieve these savings.
8 SECTION 9. It is the intent of the Idaho Legislature that the number of
9 beds in private intermediate care facilities for the mentally retarded funded
10 by Medicaid, be capped at four hundred eighty-six (486) beds, including any
11 beds planned or under construction. The department shall consult with
12 providers and advocates of persons receiving ICF/MR services on how to imple-
13 ment the cap.
14 SECTION 10. Notwithstanding the provisions of Section 56-113, Idaho Code,
15 it is the intent of the Idaho Legislature that for the period July 1, 2000,
16 through June 30, 2001, rates, including special rates, of private intermediate
17 care facilities for the mentally retarded shall not exceed the rates in effect
18 in state fiscal year 2000.
19 SECTION 11. It is the intent of the Idaho Legislature that the Department
20 of Health and Welfare require the use of generic drugs to the extent feasible
21 and allowed by law in the state's Medicaid Program. The department shall
22 develop a process of prior approval when the physician prescribes drugs other
23 than generic. The department is further directed to research the feasibility
24 of implementing a closed Medicaid drug formulary.
25 SECTION 12. It is the intent of the Idaho Legislature that a defined
26 process of prior authorization, client assessment and periodic review be
27 implemented by the department for developmental disability agency services
28 provided to clients of the state's Medicaid Program after consultation with
29 providers and advocates of persons with developmental disabilities.
30 SECTION 13. It is the intent of the Idaho Legislature that for the period
31 July 1, 2000, through June 30, 2001, the rates paid for durable medical equip-
32 ment provided to clients of the state's Medicaid Program shall not exceed the
33 rates in effect in state fiscal year 2000.
34 SECTION 14. It is the intent of the Idaho Legislature that physical ther-
35 apy services, beyond a specified amount, be prior authorized and that a con-
36 current review process be established in order to manage utilization and cost.
37 SECTION 15. It is the intent of the Idaho Legislature that the Department
38 of Health and Welfare actively oversee targeted case management services
39 received by clients of the state's Medicaid Program to ensure that clients are
40 receiving only needed services resulting in desired treatment outcomes. It is
41 further the intent of the Idaho Legislature that private targeted case man-
42 agers focus more on managing the utilization of services rather than
43 maximizing services provided to clients. The Department of Health and Welfare
44 is authorized to develop and include enforceable prior authorization and per-
45 formance requirements in provider agreements for targeted case management ser-
46 vices to carry out these objectives. The department shall consult with
47 providers and advocates of clients receiving targeted case management services
4
1 on how to effect the transition to the prior authorization and performance
2 requirements. It is further the intent of the Idaho Legislature that the
3 Department of Health and Welfare develop a plan to be implemented over a
4 period of time to better manage such services.
5 SECTION 16. It is the intent of the Idaho Legislature that mental health
6 services provided to clients of the state's Medicaid Program shall be prior
7 authorized and periodically reviewed through a defined process in order to
8 achieve cost savings. The department shall consult with providers and advo-
9 cates of clients receiving mental health services on the process for imple-
10 menting such prior authorization and periodic review.
11 SECTION 17. It is the intent of the Idaho Legislature that clients par-
12 ticipating in the state's Medicaid Program share a portion of the cost of pro-
13 viding services to the extent allowed by law. The Idaho Legislature authorizes
14 the Department of Health and Welfare to implement reasonable copayments and
15 other cost-sharing methods as allowed by law. Providers will retain all
16 copayments collected, and the Department of Health and Welfare will not reduce
17 provider reimbursement rates by the amount of the copayments.
18 SECTION 18. It is the intent of the Idaho Legislature that day treatment
19 services provided to clients with mental illness through the state's Medicaid
20 Program shall be limited to aiding in the transition from acute care to lesser
21 levels of care and to stabilization as a means of preventing hospitalization.
22 Such transition and stabilization services shall include, but not be limited
23 to, a planned program of three (3) hours per day of group therapy, one (1)
24 hour per day of individual therapy, at least two (2) psychiatric visits every
25 six (6) days, and meaningful group recreational activities. The modification
26 of day treatment services shall be phased in by January 1, 2001. The depart-
27 ment shall consult with providers and advocates of clients receiving day
28 treatment services regarding the means of modifying day treatment services to
29 transitional and stabilization services by the target date.
30 SECTION 19. It is the intent of the Idaho Legislature that the Department
31 of Health and Welfare research the feasibility of reducing Medicaid service
32 coverage to more closely match private insurance coverage when practical.
33 SECTION 20. It is the intent of the Idaho Legislature that the department
34 review the administrative costs of the Medicaid Program to assure cost-
35 effectiveness, and wherever possible, reduce the cost to be more in line with
36 the surrounding states.
37 SECTION 21. Notwithstanding any other provision of law to the contrary,
38 it is the intent of the Idaho Legislature that the Department of Health and
39 Welfare has the authority and responsibility to manage outside organizations
40 and individuals with whom the department contracts for services. This includes
41 all contracts for any services provided to or on behalf of the department.
42 SECTION 22. The Department of Health and Welfare is hereby directed to
43 promulgate the necessary rules in consultation with provider groups and cli-
44 ents in order to fully implement the Medicaid cost control measures upon which
45 this budget is based. The department shall also draft any required legislation
46 for submittal to the First Regular Session of the Fifty-sixth Idaho Legisla-
47 ture to permanently implement these changes.
| Statement of Purpose |
| RS09266C2 |
Appropriating to the Department of Health and Welfare for Medical Assistance Services $171,888,300 in General Funds, $22,853,100 in Dedicated Funds and $412,268,600 in Federal Funds for a total of $607,010,000 for fiscal year 2001; providing that the State Controller shall make transfers from the General Fund: reappropriating certain unexpended and unencumbered balances of moneys; authorizing the expenditure of all receipts collected; expressing legislative intent with regard to the Children’s Health Insurance Program; expressing legislative intent with regard to the Children’s Health Insurance Program Task Force recommendations; expressing legislative intent with regard to making state veteran’s homes Medicaid eligible; expressing legislative intent with regard to capping transportation expenditures at fiscal year 2000 levels; expressing legislative intent with regard to capping the number of beds in Medicaid funded private intermediate care facilities for the mentally retarded; expressing legislative intent with regard to capping rates for intermediate care facilities for the mentally retarded at fiscal year 2000 levels; expressing legislative intent with regard to generic drugs and directing the department to research the feasibility of implementing a closed Medicaid drug formulary; expressing legislative intent with regard to developmental disability agency services; expressing legislative intent with regard to capping rates for durable medical equipment at fiscal year 2000 levels; expressing legislative intent with regard to physical therapy services; expressing legislative intent with regard to targeted case management services; expressing legislative intent with regard to mental health services; expressing legislative intent with regard to co-payments and other cost sharing methods; expressing legislative intent with regard to day treatment services provided clients with mental illness; expressing legislative intent with regard to researching the feasibility of reducing Medicaid service coverage to more closely match private insurance coverage; expressing legislative intent with regard to administrative costs; expressing legislative intent with regard to departmental contracts; and directing the Department of Health and Welfare to promulgate rules and draft legislation.
 
| FY 2000 Original Appropriation |
162.07 |
156,563,500 |
22,853,100 |
370,830,300 |
550,246,900 |
| Reappropriation |
0.00 |
0 |
4,573,900 |
0 |
4,573,900 |
| Supplementals |
0.00 |
7,044,100 |
0 |
29,462,900 |
36,507,000 |
| FY 2000 Total Appropriation |
162.07 |
163,607,600 |
27,427,000 |
400,293,200 |
591,327,800 |
| Expenditure Adjustments |
(1.15) |
(44,300) |
0 |
(6,444,100) |
(6,488,400) |
| FY 2000 Estimated Expenditures |
160.92 |
163,563,300 |
27,427,000 |
393,849,100 |
584,839,400 |
| Base Adjustments |
0.00 |
(1,806,400) |
(4,573,900) |
(4,232,300) |
(10,612,600) |
| FY 2001 Base |
160.92 |
161,756,900 |
22,853,100 |
389,616,800 |
574,226,800 |
| Personnel Cost Rollups |
0.00 |
38,700 |
0 |
71,800 |
110,500 |
| Inflationary Adjustments |
0.00 |
3,922,000 |
0 |
9,567,700 |
13,489,700 |
| Replacement Items |
0.00 |
(125,600) |
0 |
(125,600) |
(251,200) |
| Non-Standard Adjustments |
0.00 |
3,457,700 |
0 |
8,091,800 |
11,549,500 |
| Annualizations |
0.00 |
4,522,600 |
0 |
0 |
4,522,600 |
| Change in Employee Compensation |
0.00 |
97,400 |
0 |
181,300 |
278,700 |
| Fund Shifts |
0.00 |
(2,820,100) |
0 |
2,820,100 |
0 |
| FY 2001 Program Maintenance |
160.92 |
170,849,600 |
22,853,100 |
410,223,900 |
603,926,600 |
| Enhancements |
|
|
|
|
|
| Division of Medical Assistance |
|
|
|
|
|
| 1. HCBS Waiver: Elderly & Disabled |
14.00 |
0 |
0 |
(582,400) |
(582,400) |
| 2. Replace TPR Contractors with FTP |
0.00 |
(812,600) |
0 |
(630,600) |
(1,443,200) |
| 3. Replace RCF Contract with FTP |
0.00 |
(29,400) |
0 |
(88,000) |
(117,400) |
| 4. Veterans Cemetery |
0.00 |
(40,000) |
0 |
0 |
(40,000) |
| 5. Capital Outlay Transfers |
0.00 |
2,687,400 |
0 |
6,288,500 |
8,975,900 |
| 6. Make Vet Homes Medicaid Eligible |
0.00 |
2,506,800 |
0 |
5,865,900 |
8,372,700 |
| 7. Medicaid Savings |
0.00 |
(3,273,500) |
0 |
(8,808,700) |
(12,082,200) |
| FY 2001 Total |
174.92 |
171,888,300 |
22,853,100 |
412,268,600 |
607,010,000 |
| Chg from FY 2000 Orig Approp |
12.85 |
15,324,800 |
0 |
41,438,300 |
56,763,100 |
| % Chg from FY 2000 Orig Approp. |
7.9% |
9.8% |
0.0% |
11.2% |
10.3% |
Contact: Dick Burns 334-4742
Legislative Services Office, Budget & Policy Analysis
| Statement of Purpose/Fiscal Note |
Bill No. H797 |