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Montana Senate votes to bump up Medicaid provider rates

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The sun hits the capital building in Helena late in the afternoon. ADOBE STOCK

By Keila Szpaller DAILY MONTANAN

The Montana Senate voted 49-1 this week to infuse another $15 million for the biennium from the general fund toward Medicaid provider rates — expected to be matched by another $29.5 million in federal funds.

“This is a substantial measure to bolster Montana’s senior, long-term care and other providers studied in the Guidehouse report,” said Margie MacDonald, with Big Sky 55+, in an email.

A separate bill estimated the cost to fully fund rates required another $24 million of general fund money for the biennium, still leaving a roughly $9 million gap.

Sen. John Esp, R-Big Timber, proposed the amendment to House Bill 2, the state’s big budget bill. The amendment directs the money specifically to Medicaid providers, but the House still needs to agree to the change.

Medicaid providers in Montana have been underfunded, and in the 2021 legislative session, lawmakers put $2.75 million toward a study of reimbursement rates.

A report from national consulting firm Guidehouse recommended benchmarks for different types of groups.

The Governor’s Office proposed a budget that increased reimbursement rates, but not to the recommended amount. The House approved money that pushed up reimbursements as well.

Closing nursing homes made headlines last year, and youth group homes have shut down as well.

During the session, members of the public, including nursing home directors, have testified to ask the state to support vulnerable people, workers who help them, and communities by adopting rates that match costs — or risk more closures.

If the amendment sticks, the Montana Health Care Association’s Rose Hughes said she believes nursing homes would be close to 96% of the benchmark rate in the first year, but she has yet to see a detailed analysis from the state.

A separate bill related to Medicaid providers, House Bill 649, is awaiting action in Senate Finance and Claims.

That bill, sponsored by Rep. Mary Caferro, D-Helena, would add $5 million from the general fund with a roughly $9.3 million match to the director’s office of the Department of Public Health and Human Services starting July 2024, as currently proposed.

Hughes, whose organization represents senior and long-term care providers, said HB 649 is set up in a constructive way.

She said it allows a year for health care organizations to see how the new rates are working and then offers flexibility for the state to help on an as-needed basis.

“I see a lot of benefit in a pot of money that can be used with some discretion to fix things that still need fixing,” Hughes said.

In committee, Sen. Dennis Lenz, R-Billings, wondered if the $5 million in general fund money would be enough for all the providers and questioned whether it would be better targeted to one specific group of providers.

However, Senate Finance and Claims has yet to take action on HB 649.

The one dissenting vote on the measure was Sen. Steve Hinebauch, R-Wibaux.

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