HOUSE CONCURRENT RESOLUTION NO. 144
(By Delegates Mahan, Perdue, Hatfield, Barill, Ferns, D. Campbell, Guthrie, Perry, Rodighiero, Phillips, Staggers, Border, Ellington and Rowan)
Requesting the Joint Committee on Government and Finance study the feasibility of requiring the West Virginia Department of Health and Human Resources to annually review rates of its various programs pay to health care providers.
Whereas, Medicaid spending is approaching four billion dollars annually and consumes a growing portion of West Virginia’s annual budget; and
Whereas, The Department of Health and Human Resources reimburses health care providers millions of dollars annually outside of the Medicaid program; and
Whereas, Federal health care reform is expected to add over 130,000 West Virginia residents to the Medicaid program; and
Whereas, The Department of Health and Human Resources and Medicaid reimburse providers significantly below the cost of providing services; and
Whereas, A number of providers have taken legal action against the state related to inadequate reimbursement rates and other providers are refusing to accept Medicaid patients; and
Whereas, Medicaid rates below the cost of delivering services increase the healthcare costs paid by insured and uninsured West Virginians through cost shifting; and
Whereas, The Legislature needs detailed provider rate and cost information to effectively plan, develop and manage future budgets; and
Whereas, Agencies working in the environment where expenses are changing and currently rates are not based upon the United States Department of Labor, the seasonally adjusted employment cost index; and
Whereas, An annual report would be beneficial in that the State could better determine if rate setting formulas and the processes are adequate to ensure the availability of the adequate and appropriate availability of services for the clients served; and
Whereas, This report could provide specific information on, but not be limited to, the rates paid to: physicians; hospitals; primary care centers; child care providers; behavioral health providers; MR/DD waiver providers; foster care providers; residential treatment and child care residential programs; emergency medical services agencies; chiropractors; dentists; physical therapists; day care services and homeless shelters; and
Whereas, The review may also consider the impact rates are having on access to care, cost shift to other payers, increased inflationary pressures faced by health care providers and the State’s limited resources while also comparing rates paid by the West Virginia Department of Health and Human Resources and other major payers in the State to the degree possible and applicable; therefore be it
Resolved by the Legislature of West Virginia:
That the Joint Committee on Government and Finance is hereby requested to conduct a study on requiring the West Virginia Department of Health and Human Resources to annually review rates of its various programs pay to health care providers, the potential advantages, disadvantages and barriers; and, be it
Further Resolved, That the Joint Committee on Government and Finance report to the Legislature, on the first day of the regular session, 2012 on its findings, conclusions and recommendations together with drafts of any legislation to effectuate its recommendations; and, be it
Further Resolved, That the expenses necessary to conduct this study, to prepare a report and to draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.