HB 1713 — Appropriation; Medicaid, Division of.

HB1713 (As PassedSent theto House)Governor) - 2020 Regular Session MISSISSIPPI LEGISLATURE Regular Session To:

Representatives Read, Mims, Arnold, Bounds, Clark, Clarke, Criswell, Currie, Eubanks, Hines, Hood, Sanford, Watson, Young, Foster, Anthony House Bill 1713 (As PassedSent theto House)Governor) AN ACT MAKING AN APPROPRIATION TO THE GOVERNOR'S OFFICE-DIVISION OF MEDICAID FOR THE PURPOSE OF PROVIDING MEDICAL ASSISTANCE UNDER THE MISSISSIPPI MEDICAID LAW AND DEFRAYING THE EXPENSES OF THE ADMINISTRATION OF THAT LAW FOR THE FISCAL YEAR 2021.

$   866,262,518.00.750,895,203.00.

$    4,991,217,815.00.5,414,427,360.00.

     978976 Part Time............

       24 Time-Limited:  Full Time............

       0      With the funds herein appropriated, it shall be the agency's responsibility to make certain that funds required to be appropriated for "Personal Services" for Fiscal Year 2022 do not exceed Fiscal Year 2021 funds appropriated for that purpose,purpose unless programs or positions are added to the agency's Fiscal Year 2021 budget by the Mississippi Legislature.  Based on data provided by the Legislative Budget Office, the State Personnel Board shall determine and publish the projected annual cost to fully fund all appropriated positions in compliance with the provisions of this act.  ItAbsent shalla bespecial thesituation responsibilityor ofcircumstance theapproved agencyby headthe toState ensurePersonnel thatBoard, noor singleunless personnelotherwise actionauthorized increasesby this projectedact, annualno coststate and/or the Fiscal Year 2021 appropriations for "Personal Services" when annualized, with the exception of escalated funds and the award of benchmarks.  If, at the time the agency takesshall take any action to changepromote "Personalor Services,"otherwise theaward Statesalary Personnelincreases Boardthrough determinesreallocation, thatreclassification, the agency has taken an action which would cause the agency to exceed this projected annual cost or therealignment. Fiscal Year "Personal Services" appropriated level, when annualized, then only those actions which reduce the projected annual cost and/or the appropriation requirement will be processed by the State Personnel Board until such time as the requirements of this provision are met.

If the State Personnel Board determines a special situation or circumstance exists and approves an action, then the agency and the State Personnel Board shall provide a monthly report of each action approved by the State Personnel Board to the chairmen of the Accountability, Efficiency and Transparency Committees of the Senate and House of Representatives and the chairmen of the Appropriations Committees of the Senate and House of Representatives.

 It shall be the responsibility of the agency head to ensure that no single personnel action increases this projected annual cost and/or the Fiscal Year 2021 appropriations for "Personal Services" when annualized, with the exception of escalated funds and the award of benchmarks.  If, at the time the agency takes any action to change "Personal Services," the State Personnel Board determines that the agency has taken an action which would cause the agency to exceed this projected annual cost or the Fiscal Year 2021 "Personal Services" appropriated level, when annualized, then only those actions which reduce the projected annual cost and/or the appropriation requirement will be processed by the State Personnel Board until such time as the requirements of this provision are met.

                                                          FY2021 Performance Measures                                       Target Administrative Services      Admin as a % of Total Budget                            3.00      Third Party Liability Cost Avoided ($Thou)       1,270,371.00      % of Clean Claims Processed within 30           days of receipt                                   99.50      % of Clean Claims Processed within 90           days of receipt                                  100.00      Applications Processed within Std of           Promptness (%) - Medicaid                         90.00      Third Party Funds Recovered                     4,903,690.00      Providers Submitting Electronic Claims                30,000      Turnover Rate of Employees                             15.00 Medical Services      Medicaid Recipients - Enrolled (Persons)              679,979      % MSCAN Diabetic members aged 17-75           receiving HBA1c test                              87.99      % Change in number of recipients           enrolled from last year                            1.00      % Change in number of providers from           last year                                         17.21      % MSCAN members with persistent asthma           are appropriately prescribed medication            51.37      Costs of Emergency Room Visits ($)             172,694,478.00      Number of Emergency Room Visits                      620,167      Rate of EPSDT well child screening                     75.00      % Medicaid beneficiaries assigned to a PCP             100.00      % change of Medicaid beneficiaries           assigned to a managed care company                 -2.00      Child Physical Exams (ages 0-20)                     297,379      Adult Physical Exams (21-older)                        2,891      Number of Fraud and Abuse Cases Investigated              250      Number of Kidney Dialysis Trips                      533,646      Number of Medicaid Providers                          38,715      Medicaid beneficiaries assigned a PCP                 420,000      Number of Medicaid beneficiaries           assigned to a managed care company               420,000 Children's Health Insur Prg (CHIP)(chip)      CHIP Enrollees                                        46,541      Applications Processed within Std of           Promptness (%) - CHIP                             90.00 Home & Comm Based Waiver Prg      Elderly & Disabled - Persons Served                   19,62519,580      Elderly & Disabled - Funded Slots                     19,62518,690      Elderly & Disabled - Total Authorized Slots            21,900      (E&D) Change in persons on waiting list (%)             30.0010.00      Assisted Living - Persons Served                         692690      Assisted Living - Funded Slots                           692659      Assisted Living - Total Authorized Slots                1,000      (AL) Change in persons on waiting list (%)              15.0010.00      Intellectual Disability - Persons Served                3,6503,150      Intellectual Disability - Funded Slots                 3,6502,641      Intellectual Disability - Total           Authorized Slots                                  3,650      (IDD) Change in persons on waiting list (%)             10.00      Independent Living - Persons Served                    3,1433,135      Independent Living - Funded Slots                      3,1432,993      Independent Living - Total Authorized Slots             2,7255,725      (IL) Change in persons on waiting list (%)              10.00      Traumatic Brain Injury - Persons Served                 1,0481,045      Traumatic Brain Injury - Funded Slots                 Slots                    1,048998      Traumatic Brain Injury - Total           Authorized Slots                                  1,5003,600      (TBI) Change in persons on waiting list (%)             10.00      A reporting of the degree to which the performance targets set above have been or are being achieved shall be provided in the agency's budget request submitted to the Joint Legislative Budget Committee for Fiscal Year 2022.

     SECTION 10.  Of the funds appropriated inunder the provisions of this act,act thein Divisionan ofamount Medicaidnot shallto payexceed, Two Million Seven Hundred Fifty Thousand Dollars ($2,750,000.00) is provided for the maximumpurpose rateof allowedfunding bya federaltemporary lawprogram orto regulationprovide nonemergency transportation to providerslocations offor adultnecessary daydialysis services for eachend-stage dayrenal ofdisease servicepatients providedwho toare ansixty-five eligible(65) beneficiary. years Inof orderage toor receiveolder thisor perare diemdisabled rateas determined under Section 1614(a)(3) of reimbursement,the providersfederal Social Security Act, as amended, whose income did not exceed one hundred thirty-five percent (135%) of adultthe daynonfarm servicesofficial shallpoverty participatelevel inas defined by the ElderlyOffice of Management and DisabledBudget Waiverand Programwhose foreligibility Homewas andcovered Communityunder Basedthe Services.former category of eligibility known as Poverty Level Aged and Disabled (PLADS).

     SECTION 11.  Of the funds appropriated under the provisions of this act in anSections amount1 notand to3, exceed,Three TwoHundred MillionNinety-eight SevenThousand Five Hundred Fifty Thousand Dollars ($2,750,000.00)($398,550.00) isGeneral providedFunds forand theOne purposeMillion ofOne fundingHundred aOne temporaryThousand programFour toHundred provideFifty nonemergencyDollars transportation($1,101,450.00) toSpecial locationsFunds forare necessaryprovided dialysis services for end-stagefive renal(5) diseaseslots patientsin who are sixty-five (65) years of age or older or are disabled as determined under Section 1614(a)(3) of the federalAssisted SocialLiving SecurityWaiver Act,program asfor amended,persons whosewith incomeTraumatic didBrain notInjury exceedand onein hundredneed thirty-five percent (135%) of theCognitive nonfarmRehabilitation.  officialThe povertyDivision levelshall asdevelop defined by the Office of Management and Budget and whose eligibility wascriteria coveredfor underthese theadditional formerslots. category of eligibility known as Poverty Level Aged and Disabled (PLADS).

     SECTION 12.  OfIt is the intention of the Legislature that the funds appropriated in Sectionsthis 1act to the Governor's Office - Division of Medicaid for the Mississippi Coordinated Access Network (MS-CAN) program be used in the most efficient and 3,effective Threemanner Hundredpossible Ninety-eightto Thousandachieve Fivethe Hundredintended Fiftymission Dollarsof ($398,550.00)the Generaldivision.  FundsThe division and Onethe Millioncoordinated Onecare Hundredorganizations Onewith Thousandwhich Fourthe Hundreddivision Fiftyhas Dollarscontracted ($1,101,450.00)to Specialconduct Fundsthe areMS-CAN providedprogram shall establish baselines for fivethe (5)health-related slotsoutcome inmeasurement for each of the Assistedfollowing Livinghealth Waiverfocus programareas for personspresentation withat Traumaticthe BrainJoint InjuryLegislative andBudget Committee hearings for Fiscal Year 2021, which will be used as the baseline levels for establishing targets for improvements in needquality of Cognitivecare Rehabilitation. performance Themeasures Divisionfor shallthe developMS-CAN eligibilityprogram criteriain forFiscal theseYear additional2021 slots.and later fiscal years:

     SECTION 13.  It is the intention of the Legislature that the funds appropriated in this act to the Governor's Office - Division of Medicaid for the Mississippi Coordinated Access Network (MS-CAN) program be used in the most efficient and effective manner possible to achieve the intended mission of the division.  The division and the coordinated care organizations with which the division has contracted to conduct the MS-CAN program shall establish baselines for the health-related outcome measurement for each of the following health focus areas for presentation at the Joint Legislative Budget Committee hearings for Fiscal Year 2021, which will be used as the baseline levels for establishing targets for improvements in quality of care performance measures for the MS-CAN program in Fiscal Year 2021 and later fiscal years:

     SECTION 14. 13.  ItOf is the furtherfunds intentionappropriated ofin Sections 1 and 4, Four Million One Hundred Sixty-one Thousand Ninety-five Dollars ($4,161,095.00) shall be allocated to the LegislatureDelta that,Health Alliance for the FiscalMississippi YearDelta 2021,Medicaid Population Health Demonstration Project.  Funds shall be transferred no later than July 31, 2020.  A progress report on the DivisionMississippi ofDelta Medicaid Population Health Demonstration Project shall notbe restrictprovided HIVby antiretroviralDelta medications.Health Alliance to the Chairmen of the Senate and House Public Health Committees, Senate and House Medicaid Committees and the Senate and House Appropriations Committees on or before December 31, 2020.

     SECTIONAs 15. a Ofprecondition the funds appropriated in Sections 1 and 4, Four Million One Hundred Sixty-one Thousand Ninety-five Dollars ($4,161,095.00) shall be allocated to thereceiving Deltasuch Healthfunds, Alliance for the Mississippi Delta Medicaid Population Health Demonstration Project.  Funds shall be transferred no later than July 31, 2020.  A progress report on the Mississippi Delta Medicaid Population Health Demonstration Project shall be provided by Delta Health Alliance toshall: the Chairmen of the Senate and House Public Health Committees, Senate and House Medicaid Committees and the Senate and House Appropriations Committees on or before December 31, 2020.

    (i)  SECTIONestablish 16. a Itseparate isaccount theinto intentionwhich offunds theprovided Legislatureby thatthis thesection Governor's Office - Division of Medicaid and the Department of Human Services shall continuebe todeposited work together to implement HB 1090 of the 2017 Regular Session, known as the "Medicaid and Humanaccounted; Services Transparency and Fraud Prevention Act".

    (ii)  SECTIONestablish 17. performance Themeasures Governor'sthat Officemeasure -the Divisionends of Medicaid is authorized to expendbe fundsachieved appropriatedby hereineach asprogram necessaryactivity toimplemented provideby currentlythe existingAlliance; home and community based services through any CMS approved state plan or home and community based services waiver to individuals who qualify for those services to avoid institutionalization or to transition an individual from an institution to any home and community based setting.  Provision of such services shall not count against any limit imposed under this act.

(iii)  cooperate with any firm or entity changed with the responsibility of auditing or evaluating the funds or program activities funded by this act;

(iv)  submit to the division on an annual basis reports that provide the following:

a)  number of persons served by the Alliance;

b)  amount of funds expended by the Alliance on approved activities;

c)  names of staff employed by the Alliance by position title and annual salary;

and d)  names of contractors used by the Alliance to provide services, including the amounts paid and a  description of services rendered.

     By December 1, 2023, and every three (3) years thereafter, the PEER Committee shall conduct an evaluation of the services provided by the Delta Health Alliance over the same period.  In conducting evaluations required by this section, the PEER Committee shall have access to any and all records of the Alliance.

     SECTION 14.

 It is the intention of the Legislature that the Governor's Office - Division of Medicaid and the Department of Human Services shall continue to work together to implement HB 1090 of the 2017 Regular Session, known as the "Medicaid and Human Services Transparency and Fraud Prevention Act".

     SECTION 15.  The Governor's Office - Division of Medicaid is authorized to expend funds appropriated herein as necessary to provide currently existing home and community based services through any CMS approved state plan or home and community based services waiver to individuals who qualify for those services to avoid institutionalization or to transition an individual from an institution to any home and community based setting.  Provision of such services shall not count against any limit imposed under this act.

SECTION 18. 16. It is the intent of the Legislature that the Governor's Office - Division of Medicaid shall develop a payment methodology or methodologies to reimburse rural hospitals that have fifty (50) or fewer licensed beds under a cost-based methodology pursuant to the provisions of Section 43-13-117(A)(2)(c) of the Mississippi Code or another methodology which results in increased payments for outpatient services for such hospitals.  Such payment methodology or methodologies shall be submitted to the House and Senate Appropriations Chairmen no later than December 31, 2020.

    Of SECTIONthe 19. funds Itin isSection 3, the intentionfollowing sum, or so much thereof as may be necessary, is appropriated out of theany Legislature,money in the Governor'sState OfficeTreasury -to Divisionthe credit of Medicaidthe shallCapital useExpense aFund, providerfor ownedthe companypurpose whichof isdefraying domiciledthe inexpenses of the StateGovernor's Office - Division of MississippiMedicaid withfor experiencethe infiscal credentialingyear Mississippibeginning providers.July 1, 2020, and ending June 30, 2021  $  85,048,127.00.

     SECTION 20. 17.  The money herein appropriated shall be paid by the State Treasurer out of any money in the State Treasury to the credit of the proper fund or funds as set forth in this act, upon warrants issued by the State Fiscal Officer;

     SECTION 21. 18.  This act shall take effect and be in force from and after July 1, 2020, and shall stand repealed June 30, 2020.