HB 221 Summary

• Restructures Medicaid reimbursement methodology by removing outdated rate-setting provisions and authorizing the director to determine covered services through rules rather than specific statutory language.

• Establishes nursing facility and intermediate care facility assessment funds, allowing the state to collect assessments from these providers to secure federal matching funds for Medicaid payments while capping assessments at maximum federally-allowed percentages.

• Implements Medicaid managed care reforms including tiered payment structures for primary care, elimination of duplicative services, restrictions on annual plans, and requirements that mental health providers meet national accreditation standards.

• Caps provider reimbursement at 100% of Medicare rates for primary care and 90% of Medicare rates for other services, with rate adjustments requiring legislative appropriation authority.

• Creates the "Medicaid Cost Containment and Health Care Improvement Act" directing the department to present a managed care plan focused on dual-eligible and high-risk pregnancy populations, with sunset provisions for intermediate care facility assessments effective July 1, 2012.