| 47 | | - | SECTION 1. The legislature finds that nearly one third of Hawaii's residents and half of all keiki are enrolled in medicaid. Since the start of the COVID-19 pandemic in March 2020, medicaid enrollment has increased by forty per cent. Timely access to providers can prove difficult in rural areas where health care providers are in short supply. In 2022, the State had a shortfall of more than seven hundred fifty full-time physicians and nearly four thousand other patient-facing health care workers, such as nurses, technicians, and patient service representatives. The legislature further finds that due to the significant number of Hawaii residents receiving medicaid coverage, health care providers often receive less reimbursement from medicaid than from medicare or commercial insurances for the same service. While some providers are reimbursed at cost or at the same rates as medicare, such as critical access hospitals, community health centers, and providers who perform certain services, most individual health care providers are not. Lesser reimbursements contribute to increased challenges for providers in sustaining practices and lead to some health care providers limiting or refusing to accept medicaid patients. Investing in medicaid by matching reimbursement levels to those of medicare would improve access to care by allowing more health care providers to accept medicaid patients. The legislature also finds that it is important to focus on home and community-based service providers who serve groups with high utilization of services and who have gone the longest without a rate update, such as case management agencies, community care foster family homes, and adult day health and day care centers. The Centers for Medicare and Medicaid Services is also changing payment methods for nursing facilities. State medicaid agencies will need to adopt new reimbursement methodologies that align with the new federal payment system. These all create opportunities to revise how providers of long‑term care are reimbursed to better meet current and future needs. Therefore, the purpose of this Act is to appropriate funds to increase medicaid reimbursements to eligible health care providers to match the current medicare fee schedule. SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum or so much thereof as may be necessary for fiscal year 2024-2025 to increase medicaid payments to eligible health care providers in the State up to one hundred per cent of the current medicare rates. The sums appropriated shall be expended by the department of human services for the purposes of this Act; provided that the appropriations made for fiscal year 2023-2024 by this Act shall not lapse at the end of the fiscal year for which the appropriation is made; provided further that all moneys that remain unencumbered as of June 30, 2025, shall lapse on that date. SECTION 3. This Act shall take effect on June 30, 3000. |
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| 47 | + | SECTION 1. The legislature finds that nearly one third of Hawaiis residents and half of all keiki are enrolled in medicaid. Since the start of the coronavirus disease 2019 pandemic in March 2020, medicaid enrollment has increased forty per cent. However, timely access to providers can prove difficult, especially in rural areas where health care providers are in short supply. In 2022, the State had a shortfall of more than seven hundred fifty full-time physicians and nearly four thousand nonphysician, patient-facing health care workers, such as nurses, technicians, and patient service representatives. The legislature further finds that due to the significant number of Hawaii residents receiving medicaid coverage, health care providers often receive less reimbursement from medicaid than from medicare or commercial insurances for the same service. While some providers are reimbursed at cost or at the same rates as medicare -- such as critical access hospitals, community health centers, and providers who perform certain services -- most individual health care professionals, such as physicians, psychiatrists, psychologists, and advanced practice registered nurses, are not. Lesser reimbursements contribute to the challenges providers face in sustaining practices, leading some health care providers to limit or refuse to accept medicaid patients. Investing in medicaid by matching reimbursement levels to those of medicare would allow more health care providers to accept medicaid patients, improving access to care. Therefore, the purpose of this Act is to appropriate funds to increase medicaid reimbursements to eligible health care professionals to match the current medicare fee schedule. SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $30,000,000 or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum or so much thereof as may be necessary for fiscal year 2024-2025 to increase medicaid payments to eligible health care professionals in the State up to one hundred per cent of the current medicare rates. The sums appropriated shall be expended by the department of human services for the purposes of this Act. SECTION 3. The appropriations made by this Act shall not lapse at the end of the fiscal year for which the appropriation is made; provided that all moneys from the appropriation unencumbered as of June 30, 2025, shall lapse as of that date. SECTION 4. This Act shall take effect on July 1, 2023. INTRODUCED BY: _____________________________ |
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