H. B. 4631
(By Delegates P. White, Douglas, Brown, Compton,
Rutledge, Yeager and Leach)
[Introduced February 28, 1994; referred to the
Committee on Health and Human Resources then Finance.]
A BILL to amend article four-a, chapter nine of the code of West Virginia, one thousand nine hundred thirty-one, as amended, by adding thereto a new section, designated section two-b, relating to expansion of medicaid coverage to children and terminally ill with maximal use of federal funds; initiating the option of hospice care to terminally ill; initiation of a single case management system for the medicaid waiver population; requiring annual reports from the health care cost authority to the governor and Legislature regarding the number of children and elderly covered by the expanded program, the cost of services by type and service provided and a cost-benefit analysis of the effect of expansion on other insurers and the reduction of uncompensated care in hospitals due to the expansion; requiring consideration of the reduction of uncompensated care and charity care in the rate review process for hospitals; requiring annual reports from the health care cost authority to the governor and the Legislature concerning the reduction in cost shift created by the expansion of medicaid coverage and recommendations for additional expansions which would further reduce cost shifting of the uninsured to other payors; and allowing use of the medical services trust fund to pay for the expansion of coverage.
Be it enacted by the Legislature of West Virginia:
That article four-a, chapter nine of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended by adding thereto a new section, designated section two-b, to read as follows:
ARTICLE 4A. MEDICAID UNCOMPENSATED CARE FUND.
§9-4A-2b. Expansion of coverage to children and terminally ill.
(a) It is the intent of the Legislature that steps be taken to expand coverage to children and the terminally ill and to pay for this coverage by maximizing federal funds. To achieve this intention, the department of health and human resources shall undertake the following:
(1) Effective the first day of July, one thousand nine hundred ninety-four, the department shall initiate a streamlined application form, which shall be no longer than two pages, for all families applying only for medicaid coverage for children.
(2) Effective the first day of July, one thousand nine hundred ninety-four, the department shall initiate the medicaid option to expand coverage of medicaid to all West Virginia children whose family income is below one hundred fifty percent of the federal poverty level.
(3) Effective the first day of July, one thousand nine hundred ninety-four, the department shall initiate the option of hospice care to terminally ill West Virginians who otherwise qualify for medicaid.
(4) Effective no later than the first day of July, one thousand nine hundred ninety-four, the department shall initiate a single case management system for the medicaid waiver population. The system shall eliminate all duplication of case management in every county of this state and provide for the immediate transition of the terminally ill from the waiver program into the hospice care option.
(b) On the first day of January, one thousand nine hundred ninety-five and annually thereafter, the authority shall report to the governor and to the Legislature information regarding the number of children and elderly covered by the program, specifically in subsections (2) and (3) of this section, the cost of services by type of service provided, a cost-benefit analysis of the expansion on other insurers and the reduction of uncompensated care in hospitals as a result of expansion.
(c) The health care cost review authority established by section five, article twenty-nine-b of this chapter shall consider in its rate review that uncompensated care and charity care are reduced by this expansion and shall take the reduction into account when determining rates. This determination shall be undertaken in each hospital's next rate review and shall be determined prospectively.
(d) On the first day of January, one thousand nine hundred ninety-five, and annually thereafter, the authority shall present to the governor and to the Legislature a report concerning the reduction in cost shift created by the operation of the provisions of this article and shall identify and recommend any additional medicaid expansions which would further reduce cost shifting of the uninsured to other payors.
(e) Notwithstanding the provisions of section two-a, article four-a, chapter nine of this code, funds from the medical services trust fund may be utilized to pay for the expansion specified in subsections (2) and (3) of this section.
NOTE: The purpose of this bill is to provide expanded medicaid coverage to children and terminally ill West Virginians. The bill initiates a single case management system for the medicaid waiver population and the option of hospice care to terminally ill West Virginians. It requires annual reports from the health care cost review authority to the governor and the Legislature concerning the number of people covered by the expanded program, reductions in cost shift, and recommendations for additional expansions to further reduce cost shifting of the uninsured to other payors. The bill also allows use of the medical services trust fund to pay for the expansion of coverage.
§9-4A-2b is new; therefore, strike-throughs and underscoring have been omitted.