November 1, 2005

Medicaid Reform Commission Meets For First Work Session

This week, the Missouri Medicaid Reform Commission met at the state Capitol on Wednesday and Thursday to begin crafting its recommendations. The committee’s report to the General Assembly is due Jan. 1, 2006.

The meetings were designed to compile a list of proposals, comments and ideas that the individual commission members want the group to consider. The commission will begin the process of selecting and refining recommendations from the list at its next work session Nov. 9-10. Commission Co-chair Sen. Charlie Shields, R-St. Joseph, noted the commission is open to discussing any idea submitted by a member, but not all ideas will be included in the final report.

The Wednesday meeting began with a report from Julie Eckstein, director of the Missouri Department of Health and Senior Services, on a recent National Conference of State Legislatures meeting on Medicaid. This was followed by a review of key ideas from the commission’s previous hearings to gather testimony on various topics.

Shields suggested all ideas be classified in one of the following three categories.

• best practices that would not require statutory change
• proposals that would require statutory approval
• proposals that would require a federal Medicaid waiver — Gary Sherman, director of the Missouri Department of Social Services, suggested submitting all approved ideas under one “demonstration project” request to the federal government, instead of submitting each idea under a separate waiver.

Several hundred suggestions were proposed to the committee, including the following.

• consider whether to continue certificate of need review of nursing homes and/or hospitals
• establish pay for performance reimbursement systems
• equalize reimbursement rates, especially in relation to federally qualified health centers
• promote public reporting of provider quality indicators
• expand Medicaid managed care to new areas and populations
• promote electronic medical records and prescribing systems
• develop incentives to give recipients a financial stake in their utilization and lifestyle decisions
• merge the Missouri Consolidated Health Care Plan with Medicaid to gain greater volume-based discounts
• take additional steps to determine fraud and abuse

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