March 12, 2024

See attached document for Assembly bill.

1)It appears the Assembly has accepted the commercial rate mandate proposal meaning that we now have general 3-way support for this groundbreaking reform. The Assembly language takes great pains to ensure providers can still negotiate in-network commercial rates BUT the rate ultimately paid must be (at a minimum) the same as the Medicaid rate.  The only change made by the Assembly requires the DoH to set a Medicaid rate on April 1 of each year and commercial insurers are required to pay that rate regardless of any Medicaid APG rate changes during that year.  This addresses health plans concerns over constantly changing APG government rates.

2)  The Assembly supports the COLA moving to 3.2% however it appears the Assembly restricts the COLA (similar to the Senate proposal) to wages/salaries for non-executive staff.

3)  Unclear what’s happening with OMIG Audit Reform in the Assembly one house.  We are still looking.

4)  Assembly one house adds FQHCs to the list of telehealth provider types that will be paid at face-to-face rates until the law expires.   (Senate concurs)

5)  Assembly one house appears to accept the Governor’s Competitive Procurement proposal. (Senate rejected)

6) The Assembly has language that (similar to the Senate version) requires the state to apply for a federal waiver allowing it to create a new MCO Tax however the language does not appear to be as restrictive re: provider types that can benefit from these funds.  (Senate proposal expressly excludes Article 16, 31, 32).

Stand by for more.