HB126INTRODUCED Page 0 WV1H5E-1 By Representatives South, Reynolds RFD: Ways and Means General Fund First Read: 21-Mar-23 1 2 3 4 5 WV1H5E-1 03/03/2023 EBO-DHC EBO JT EBO-2023-17 Page 1 SYNOPSIS: This bill creates the Medicaid Emergency Reserve Fund and provides for the withdrawal and use of the amounts deposited into the fund. A BILL TO BE ENTITLED AN ACT To create the Medicaid Emergency Reserve Fund and to provide for the withdrawal and use of amounts deposited into the fund. BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: Section 1. This Act shall be known as the Medicaid Emergency Reserve Fund Act. Section 2. The Legislature finds that it is in the best interest of the State of Alabama that the Alabama Medicaid Agency is not forced to reduce payments to medical providers or eliminate optional but essential medical benefits to Medicaid recipients when the fiscal year appropriation is insufficient to continue the operations of the Medicaid program. It is the intent of the Legislature that there be a Medicaid Emergency Reserve Fund to ensure the continued operation of the Alabama Medicaid Agency during budget 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 HB126 INTRODUCEDHB126 INTRODUCED Page 2 shortfalls. Section 3. There is hereby created in the State Treasury a fund to be known as the Medicaid Emergency Reserve Fund. The fund shall be administered in accordance with the provisions of this article. The fund shall be budgeted and allotted in accordance with Sections 41-4-80 through 41-4-96 and Sections 41-19-1 through 41-19-12. Section 4.(a) The Medicaid Emergency Reserve Fund shall only be used for the following reasons: (1) To cover expenditure variances due to cost increases; (2) To cover expenditure variances due to unforeseen cost; or (3) To prevent overdraft or deficit if the Alabama Medicaid Agency is expected to expend its total State General Fund appropriation before the end of the fiscal year. (b) Funds in the Medicaid Emergency Reserve Fund shall only be used by the Alabama Medicaid Agency when authorized by the Governor. (c) The Alabama Medicaid Agency must exhaust its appropriation from the State General Fund for the fiscal year in which the Governor approves the release before any funds from the Medicaid Emergency Reserve Fund are utilized. Section 5.(a) The Commissioner of the Alabama Medicaid Agency shall notify the Governor when he or she foresees that the Alabama Medicaid Agency will exhaust its State General 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 HB126 INTRODUCEDHB126 INTRODUCED Page 3 Fund appropriation within 180 days or less due to any of the reasons stated in Section 4(a). The notification must include a detailed explanation of why the State General Fund appropriation will be exhausted, the anticipated amount of funds necessary to continue the operation of the Medicaid program until the next fiscal year, and the effect on the Medicaid program if the Alabama Medicaid Agency is unable to utilize funds from the Medicaid Emergency Reserve Fund. (b) The Commissioner of the Alabama Medicaid Agency shall contemporaneously send the same notification to the Chairman of the Senate Finance and Taxation Committee-General Fund, and the Chairman of the House Ways and Means Committee-General Fund, the State Finance Director, and the Legislative Fiscal Officer. Section 6.The Governor shall notify the Commissioner of the Alabama Medicaid Agency, the Director of Finance, and all persons listed in Section 5(b) of his or her decision to release funds in the Medicaid Emergency Reserve Fund. The Governor shall include the maximum amount of funds from the Medicaid Emergency Reserve Fund that may be released. Section 7.At the end of fiscal year 2024, and at the end of every fiscal year thereafter, the unencumbered balance of both the Medicaid State General Fund Account, Account No. 0106, and the Medicaid State General Fund Carryforward 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 HB126 INTRODUCEDHB126 INTRODUCED Page 4 Account, Account No. 0110, that was not appropriated in a future budget, shall be transferred to the Medicaid Emergency Reserve Fund no later than November 15 of the following fiscal year. Each year the legislature shall appropriate the expected carryforward in the Medicaid Emergency Reserve Fund back to the fund for use in the next fiscal year. Each year the legislature shall also appropriate any expected transfers from both the Medicaid State General Fund Account, Account No. 0106, and the Medicaid State General Fund Carryforward Account, Account No. 0110, to the Medicaid Emergency Reserve Fund. Section 8.(a) In addition to all other appropriations, there is hereby appropriated $88,000,000 to the Medicaid Emergency Reserve Fund for the state fiscal year ending September 30, 2024. (b) In addition to all other appropriations, there is hereby appropriated $88,000,000 from the Medicaid Emergency Reserve Fund to the Alabama Medicaid Agency to be used in conformity with this Act during the state fiscal year ending September 30, 2024. Section 9.The balance in the Medicaid Emergency Reserve Fund shall not exceed $100,000,000. No transfers may be made to the Medicaid Emergency Reserve Fund if the balance is $100,000,000. 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 HB126 INTRODUCEDHB126 INTRODUCED Page 5 Section 10.The State Treasurer shall invest the funds in the Medicaid Emergency Reserve Fund in investments which are eligible investments for the Alabama Trust Fund as authorized by Amendment No. 450 and Amendment No. 488 of the Constitution of Alabama of 1901. All interest earned on the investment of money in the reserve fund shall be credited to the State General Fund. The State Treasurer shall receive no fees or compensation for his or her work in complying with this provision. Section 11. This act shall be effective upon its passage and approval by the Governor, or its otherwise becoming law. 102 103 104 105 106 107 108 109 110 111 112 113