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Mississippi House threatens Medicaid budget in rules dispute

Mississippi House members on Sunday threatened to torpedo next year's $6 billion budget for the state-federal Medicaid health insurance program, unless senators agree to rule changes.

Posted: Mar. 25, 2018 8:48 PM

JACKSON, Miss. (AP) — Mississippi House members on Sunday threatened to torpedo next year's $6 billion budget for the state-federal Medicaid health insurance program, unless senators agree to rule changes.

Representatives sent the 2019 budget back for more talks with the Senate, demanding that the Senate agree on a rules bill before the House approves the budget.

Among other things, House members have been seeking another opportunity for the state's hospitals to bid on part of the Medicaid program's managed care business. The Senate is resisting that demand after the Medicaid agency rejected a bid from a hospital group last summer.

If the House and Senate can't agree on provisions in what's known as the Medicaid technical amendments bill, all the existing rules would end June 30. That would give Gov. Phil Bryant full control of the program, subject to federal approvals.

Rep. Becky Currie, a Brookhaven Republican, warned that was exactly what was about to happen.

"We're tired, we're ready to go home, but I'm not tired enough to give up my authority on the Medicaid tech bill," Currie told House members. "Do not fund Medicaid until we get a tech bill. It is vital. Hear me."

The move came as the House passed many of the bills needed to fund Mississippi's $6.1 billion state budget for the year beginning July 1. A summary distributed to House members shows that K-12 education, community colleges and universities would get basically the same amount of money as in the current year. Getting boosts would be the Department of Human Services, the Department of Child Protection Services, the Department of Rehabilitation Services, the state medical examiner's office and the state prison system.

Total projected state spending would increase $22 million, less than one-half percent, above the $6.07 billion the state is spending this year. Talks continue on some bills, including K-12, community college and university funding, but it's unclear if any more total money could be allotted to those agencies.

One in four Mississippians are insured under Medicaid, including people in nursing homes, disabled adults, pregnant women and young children. The technical amendments bill, Senate Bill 2836 , has been subject to heavy lobbying by hospitals, managed care insurers and other interests. It governs things like reimbursement rates to physicians and other health care providers and whether nursing homes will have to negotiate for payment rates with managed care companies.

Lt. Gov. Tate Reeves hasn't even officially named negotiators, although a conference report must be filed by Monday night. Rep. Jason White, a West Republican, said he's been talking to Senate Medicaid Committee Chairman Brice Wiggins, a Pascagoula Republican. West said it if was up to him and Wiggins, they could work something out.

"However, Chairman Wiggins isn't calling the shot on the Senate end and I think the jury's out on exactly what his boss wants down there," West said of Reeves.

Laura Hipp, a spokeswoman for the Republican lieutenant governor, said senators are not trying to kill the technical amendment bill.

West said senators want to let managed care insurers negotiate for lower payment rates, unlike the House, which wants to maintain at least some rates set in law. House members also want to remove limits on physician visits and prescriptions by Medicaid beneficiaries.

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