Senate Bill No. 457
(By Senators Walker, Tomblin, Mr. President, Wooton, Fanning,
Hunter, Macnaughtan, Craigo, Oliverio, Sharpe, Dittmar, Bailey,
Bowman, Snyder, Kessler, Prezioso, Buckalew, Jackson, White,
Plymale, Anderson, McKenzie, Sprouse, Chafin, Ball, Ross,
Schoonover, Scott, Love, Helmick, Minear and Boley)
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[Introduced February 10, 1998; referred to
the Committee on Health and Human Resources;
and then to the Committee on Finance.]
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A BILL to amend and reenact section two-b, article four-a,
chapter nine of the code of West Virginia, one thousand nine
hundred thirty-one, as amended; and to further amend said
article by adding thereto a new section, designated section
three, all relating to the state's medicaid program;
providing for health insurance coverage of children under
the age of six if their family income is below one hundred
fifty percent of the federal poverty level; and creating the
West Virginia children's health care fund.
Be it enacted by the Legislature of West Virginia:
That section two-b, article four-a, chapter nine of the code
of West Virginia, one thousand nine hundred thirty-one, as
amended, be amended and reenacted; and that said article be
further amended by adding thereto a new section, designated
section three, all 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 fully utilizing 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 ninety-eight, the department shall initiate
a streamlined application form, which shall be no longer than two
pages, for all families applying only for medicaid medical
coverage for children under any of the programs set forth in this
section.
(2) 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. On or before the first day of January, one thousand nine hundred ninety-five, and periodically thereafter,
The department shall report provide quarterly reports to the
legislative task force on uncompensated health care and medicaid
expenditures oversight commission on health and human resources
accountability created pursuant to section four, article
twenty-nine-c twenty-nine-e, chapter sixteen of this code
regarding the program initiation provided for in this
subdivision. The report shall include, but not be limited to,
the total number, by age, of newly eligible clients served, as
a result of the initiation of the program pursuant to this
subdivision the average annual cost of coverage per client, and
the total cost, by provider type, to serve all clients.
(3) Effective the first day of July, one thousand nine
hundred ninety-four, the department shall accelerate the medicaid
option for coverage of medicaid to all West Virginia children
whose family income is below one hundred percent of the federal
poverty level. On or before the first day of January, one
thousand nine hundred ninety-five, and periodically thereafter,
The department shall report provide quarterly reports to the
legislative task force on uncompensated health care and medicaid
expenditures oversight commission on health and human resources
accountability regarding the program acceleration provided for in
this subdivision. The report shall include, but not be limited
to, the number of newly eligible clients, by age, served as a result of the acceleration, the average annual cost of coverage
per client and the total cost of all clients served by provider
type. The report shall also include the medical services trust
fund balance and the future disproportionate share moneys
expected to be deposited in the medical services trust fund
pursuant to section two-a of this article.
(4)Effective the first day of July, one thousand nine
hundred ninety-five ninety-eight, the department may initiate the
medicaid option to shall expand the current medicaid coverage of
children below the age of six years whose family income is below
one hundred thirty-three percent of the federal poverty level to
include those West Virginia children below the age of six years
whose family income is between one hundred thirty-three percent
of the federal poverty level and one hundred fifty-percent of the
federal poverty level. This program shall be administered in
accordance with the applicable provisions of Titles XIX and XXI
of the Social Security Act. To prepare for program expansion the
department shall submit a report to the governor and the
Legislature on the first day of January, one thousand nine
hundred ninety-five, regarding the feasibility of the expansion.
The report is to include, but not be limited to, the number of
newly eligible clients participating in the programs specified in
this section, the average annual cost of coverage per client, the
percentage of expected participation for the expansion, the projected cost of the expansion, the medical services trust fund
balance and the future disproportionate share moneys expected to
be deposited in the medical services trust fund pursuant to
section two-a of this article. The department shall continually
update the additional information required to be provided to the
governor and the Legislature regarding this expansion and
periodically report the information to the legislative task force
on uncompensated health care and medicaid expenditures created
pursuant to section four, article twenty-nine-c, chapter sixteen
of this code.
(5) Effective the first day of July, one thousand nine
hundred ninety-six, the department may 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. To prepare for program expansion,
the department shall submit a report to the governor and the
Legislature on the first day of January, one thousand nine
hundred ninety-six, regarding the feasibility of the expansion.
Additionally, the report is to include, but not be limited to,
the number of clients who would be newly eligible to participate
in the program, the average annual cost of coverage per client,
by age, the percentage of expected participation for the
expansion and the projected cost of the expansion, the balance of
the medical services trust fund and the future disproportionate share moneys expected to be deposited in the medical services
trust fund pursuant to section two-a of this article. The
department shall periodically update and report to the
legislative task force on uncompensated health care and medicaid
expenditures created pursuant to section four, article twenty- nine-c, chapter sixteen of this code regarding the additional
information required to be submitted to the governor and the
Legislature.
(b) Notwithstanding the provisions of section two-a of this
article, the accruing interest in the medical services trust fund
may be utilized to pay for the programs specified in subdivisions
(2) and (3), subsection (a) of this section: Provided, That to
the extent the accrued interest is not sufficient to fully fund
the specified programs, the disproportionate share hospital funds
paid into the medical services trust fund after the thirtieth day
of June, one thousand nine hundred ninety-four, may be applied to
cover the cost of the specified programs. Provided, however,
That in fiscal year one thousand nine hundred ninety-five, the
amount of funds applied from the disproportionate share funds,
not including accrued interest, shall not exceed ten million
dollars: Provided further, That in the interest of fiscal
responsibility, the department shall terminate the program
specified in subdivisions (4) and (5) of subsection (a) of this
section, if the future moneys deposited from disproportionate share payments in the medical services trust fund are
insufficient to cover the cost of the expanded program.
(c) On the first day of January, one thousand nine hundred
ninety-five and annually thereafter, the department shall report
to the governor and to the Legislature information regarding the
number of children and elderly covered by the program programs in
subdivisions (2) and (3), subsection (a), of this section, the
cost of services by type of service provided, a cost-benefit
analysis of the acceleration and expansion on other insurers and
the reduction of uncompensated care in hospitals as a result of
the programs.
(d) On the first day of January, one thousand nine hundred
ninety-nine and annually thereafter, the department shall report
to the governor and to the Legislature information regarding the
number of children enrolled in the Title XIX medicaid program as
a result of implementation of the provisions of subdivision (4),
subsection (a) of this section; the number of children enrolled
in the new Title XXI medicaid program; the estimated number of
children eligible for enrollment in either program; the cost of
services by type of service provided in both programs; an
analysis of the impact of the programs on other insurers; and the
reduction of uncompensated care in hospitals as a result of the
programs. The annual report filed by the department shall also
include information relating to any proposed expansion of the population to be served under the state's medicaid program, other
than the expansions specifically authorized in this section, and
any expansion in the population to be served may not be
implemented until sixty days following the filing of the report
required in this subsection. The department shall make quarterly
reports to the legislative oversight commission on health and
human resources accountability, established pursuant to section
four, article twenty-nine-e, chapter sixteen of this code
regarding the development, implementation and monitoring of the
program.
(d) (e)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 the programs specified in subsection (a) of
this section 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.
(e) (f) On the first day of January, one thousand nine
hundred ninety-five ninety-nine, and annually thereafter, the
health care cost review 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.
(f) The department shall review the additional utilization by behavioral health centers as a result of the acceleration and
expansion for a period of eighteen months from the enactment of
this article: Provided, That during the eighteen month study
period the department shall not issue additional behavioral
health licenses: Provided, however, That this license provision
does not apply to facilities filing for renewal applications or
to any health care facility which has a certificate of need in
effect or an application pending on the first day of March, one
thousand nine hundred ninety-four: Provided further, That this
licensure prohibition shall not apply to behavior health services
provided pursuant to any agreement between state owned
psychiatric hospitals which are approved by the federal health
care finance administration.
§9-4A-3. The West Virginia children's health fund.
(a) There is hereby created in the state treasury a special
revolving fund to be known as the "West Virginia children's
health fund," which shall be an interest-bearing account
established and maintained to purchase health services for low- income children.
(b) Funds paid into this account shall be derived from the
following sources:
(1) Any appropriations by the Legislature;
(2) All public funds transferred by any public agency as
permitted by applicable federal and state law;
(3) Any private funds contributed, donated or bequeathed by
corporations, individuals or other entities as permitted by
applicable federal and state law; and
(4) All interest or return on investments accruing to the
fund.
(b) Moneys from this fund shall be used exclusively for the
following purposes:
(1) To purchase health care services for the program defined
in subdivision (4), subsection (a), section two-b of this
article, and to pay for associated administrative costs; outreach
activities and presumptive eligibility costs; and
(2) To provide the state's share of the enhanced federal
medical assistance percentage funds.
(c) Notwithstanding the provisions of section two, article
two, chapter twelve of this code, funds of the West Virginia
children's health fund may not be redesignated for any purpose
other than those set forth in this subsection.
NOTE: The purpose of this bill is to provide health
insurance for children under the age of six if their family
income is below one hundred fifty percent of the federal poverty
level; and creating the West Virginia Children's Health Care
Fund.
Strike-throughs indicate language that would be stricken
from the present law, and underscoring indicates new language
that would be added.
§9-4A-3 is new; therefore, strike-throughs and underscoring have been omitted.