Members of the health, behavioral health and aging work group reviewed a House Appropriations & Finance Committee (HAFC) scenario that repackages Health Care Authority (HCA) January Medicaid projections to fund targeted increases across provider types and department staffing.

The discussion began with HCA staff reporting that a January budget projection left additional room within Medicaid appropriations. The scenario presented to the work group moves several line items toward the executive recommendation while keeping the LFC general fund total unchanged. HCA staff cited highlighted adjustments including PACE (Program for All-Inclusive Care for the Elderly) at “53, 5,300,000.0,” assisted living facilities at 2,500,000.0 and nursing facility rebasing at 9,000,000.0. The scenario also adds funding to allow the secretary’s office to fill vacancies and make some salary adjustments within the department (amount not specified in the meeting).

Representative Berndon asked how pending bills would be reflected. Staff said birthing-center parity language was already included in the LFC recommendation; language or funding for a bill on reimbursement for vagus nerve stimulation was not included in this scenario and would require analysis with the agency to estimate Medicaid impact.

The work group discussed provider-rate adjustments for the Developmental Disability Support Division but did not provide a detailed dollar amount in the meeting; staff said they had “brought that up a little bit” to give providers a larger rate adjustment. On the backside of the packet, staff said the income support division lines were moved to the executive recommendation and program support included an additional $600,000. The Division of Health Improvement also received $600,000 for fee replacement, per the scenario.

When asked whether these changes affected the overall House Bill 2 general fund bottom line, staff said the adjustments were done within the LFC general fund allocation so the net cost to House Bill 2 would be unchanged. HCA staff and analysts explained the lower Medicaid projection reflected fewer people expected to be on the program next fiscal year; that reduced caseload estimate produced the savings being reallocated to the items discussed.

No formal motions or roll-call votes were recorded on these adjustments during the work group discussion.