ID H0039

Department may enter into voluntary agreements with Medicaid providers to pay for services based on measurable health care quality and positive health outcomes.

Any value-based payment agreement must be designed to be cost-neutral or cost-saving compared to other payment methodologies.

Department is authorized to pursue federal waiver agreements to support value-based payment arrangements, including fully capitated provider-based managed care.

Existing provider payment rates remain: up to 100% of Medicare rate for primary care procedure codes and 90% for all other procedure codes, with 91% rate for adolescent mental health facility services.

All changes to provider payment rates continue to require legislative approval through the annual appropriation process.