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Nov. 19, 2017
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Minutes for SB94 - Committee on Ways and Means

Short Title

Increasing the health maintenance organization privilege fee and extending the medical assistance fee fund.

Minutes Content for Mon, Feb 6, 2017

Chairperson McGinn opened the hearing on SB 94.  Scott Abbott provided an overview of the bill.  (Attachment 3)  Jennifer Oullette provided an overview of the fiscal note. 

Chad Austin testified in support of the bill.  The bill would restore funding of the Medicaid provider cuts that greatly exacerbated an already stressed health care system. For FY 18, this bill would generate enough to make up for the losses and would provide sustainability for the program.  Mr. Austin responded to questions from Committee members.  (Attachment 4)

Dr. Sam Antonios, MD, spoke as a proponent of the bill.  The reimbursement cuts have had a crippling effect on Via Christi and resulted in a negative financial position for them of approximately $6.6M annually.  The Governor's decision to balance the budget on the backs of hospitals and healthcare systems was implemented with very short notice.  Via Christie is in a position of considering pulling back services from KanCare recipients.  (Attachment 5)

Peter Stern stood in favor of the bill as it would restore reimbursements to pharmacies participating in the KanCare program.  Pharmacists have seen KanCare reimbursement reduced in several ways over the last year and this would help restore reimbursements to the level provided before the cuts in 2016.  (Attachment 6)

Kyle Kessler testified in support of the bill.  Community Mental Health Centers (CMHCs) are required to provide services regardless of the recipient's ability to pay and they are estimating the CMHCs will experience an estimated $11 million loss in 2017.  If the bill is not passed, the CMHCs would likely experience a reduction in employees and services.  (Attachment 7)

Rachel Monger supports the bill as nursing homes, particularly in rural communities, are faltering due to the unsustainable burden of rate cuts for Medicaid providers as well as the Medicaid eligibility backlog.  In 2016, four LeadingAge Kansas facilities closed and two more were sold to for-profit nursing home chains--all but one were in rural communities.  (Attachment 8)

Terica Gatewood spoke as a proponent of the bill.  Genoa provides pharmacy services for Community Mental Health Centers throughout the state.  The cuts from last year threaten their ability to continue to provide the same level of services because over 40% of their patients rely on Medicaid for prescription drug coverage.  (Attachment 9)

Ron Hein testified in support of the bill as it would generally allow the KanCare MCOs to be made whole and large chain pharmacies have been subjected to cuts ranging from 12-57%.  (Attachment 10)

Denise Cyzman spoke in favor of the bill as safety net clinics provide services regardless of people's ability to pay and, since their primary reimbursement is through Medicaid and CHIP, they have a lower financial margin. This would be an investment back in the healthcare system.  (Attachment 11)

Cindy Luxem testified as a proponent of the bill.  The nursing home profession has done what needs to be done in good faith and this cut, on top of the problems with the Medicaid eligibility process, makes the situation untenable.  Ms. Luxem responded to questions from Committee members.  (Attachment 12)

Written testimony in support of the bill was submitted by:

Coni Fries testified in opposition to the bill.  Insurance companies have been hit hard with Affordable Care Act and this tax couldn't come at a worse time.  If passed, this legislation would require the fee to be imposed retroactively so insurance companies would not be able to include it in rates for this year.  Ms. Fries responded to questions from Committee members.  (Attachment 20)

Clark Shultz spoke as an opponent to the retroactive aspect of the bill.  If passed in its present form, the bill will increase the already existing turmoil for those in the health insurance marketplace.  (Attachment 21)

Mike Randol provided neutral testimony as there is potential risk related to pass-through payments.  Mr. Randol responded to questions from Committee members.  (Attachment 22)

Chairperson McGinn left the hearing open on SB 94.

Chairperson McGinn adjourned the meeting at 11:49.  The next meeting will be held on February 7, 2017.