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Legislative Year: 2022 Change
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Bill Detail: SB22-236

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Title Review Of Medicaid Provider Rates
Status Governor Signed (06/07/2022)
Bill Subjects
  • Health Care & Health Insurance
House Sponsors K. Ransom (R)
J. McCluskie (D)
Senate Sponsors B. Rankin (R)
C. Hansen (D)
House Committee Appropriations
Senate Committee Appropriations
Date Introduced 04/28/2022
Summary

Joint Budget Committee. Current law requires the department of
health care policy and financing (state department) to establish a schedule
for a review of provider rates paid under medicaid so that each provider
rate is reviewed at least every 5 years and to provide the schedule to the
joint budget committee (JBC). Beginning August 1, 2023, the bill
requires the state department to establish a schedule so that each provider
rate is reviewed at least every 3 years and to provide the schedule to the
medicaid provider rate review advisory committee (advisory committee)

in addition to the JBC.
Current law authorizes the advisory committee or the JBC, by a
majority vote, to direct the state department to conduct a review of a
provider rate that is not scheduled for review during that year. Effective
August 1, 2023, if the state department determines the request for an
out-of-cycle review cannot be conducted, the bill requires the state
department to provide written notification to the advisory committee and
the JBC within 30 days after the request is made stating the reasons the
out-of-cycle request cannot be conducted.
Effective August 1, 2023, the bill requires the state department to
utilize information made available by the state department concerning the
prior authorization process and billing structure for provider rates if such
information is relevant to the review in order to minimize rate disparities
for services in professional classifications that are eligible for
reimbursement under medicaid.
Effective August 1, 2023, the bill requires the state department to
conduct a public meeting at least quarterly to inform the state
department's review of provider rates.
Current law requires the advisory committee consist of 24
members. Effective August 1, 2023, the bill decreases the advisory
committee to 7 members and requires the members to have proven
expertise related to medicaid in one or more specific areas. The advisory
committee is currently scheduled to sunset September 1, 2025. The bill
moves the sunset to September 1, 2036.
On or before December 1, 2024, and each December 1 thereafter,
the bill requires the advisory committee to present to the JBC an overview
of the provider rate review process, a summary of the provider rates that
were reviewed, and the strategies for responding to the findings of the
provider rate review.

Committee Reports
with Amendments
Full Text
Full Text of Bill (pdf) (most recent)
Fiscal Notes Fiscal Notes (04/30/2022) (most recent)  
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