A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See HF 525, HF 685.)
Impact
The enforcement of the premium tax is expected to bolster the financial resources available for Medicaid services by depositing gathered funds into a designated 'Medicaid managed care organization premiums fund.' This fund will ensure that unencumbered or unobligated funds at the fiscal year-end remain available for medical assistance purposes, enhancing the sustainability of the Medicaid program. Additionally, the bill mandates that third-party entities—such as insurers—acknowledge their responsibility to provide support for medical costs, positioning Medicaid as the payor of last resort in cases where alternative funding sources are available for services rendered.
Summary
House Study Bill 177 proposes amendments related to the Medicaid program, particularly focusing on the taxation of health maintenance organizations (HMOs) and guidelines for recovering costs from third parties that may be responsible for medical expenses. The bill aims to revise existing code regarding the financial obligations of HMOs in managing services related to individuals eligible for Medicaid, ensuring that these organizations bear a defined tax responsibility while providing medical assistance. Specifically, it introduces a new premium tax of 2.5% on HMOs engaged with the Department of Health and Human Services (HHS) for administering the medical assistance program, beginning January 1, 2024.
Contention
Notably, the bill may stir contention regarding the obligation imposed on third parties to cooperate with Medicaid payors in identifying and recovering benefits. All sources of potential coverage must now be clarified, and failure to do so can result in them being barred from doing business within the state. Supporters argue that these measures are necessary to ensure that Medicaid resources are recouped effectively and efficiently, while critics may view it as an additional bureaucratic hurdle for those seeking care or managing claims under Medicaid's existing framework. The clarity on third-party obligations and the expectation for compliance could also raise discussions about privacy and responsibilities among healthcare providers.
Related
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See SF 462, SF 567.)
IA SF462
Replaced by
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly SSB 1167; See SF 567.)
IA HF525
Replaced by
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly HSB 177; See HF 685.)
IA HF685
Replaced by
A bill for an act relating to health care services and financing, including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums. (Formerly HF 525, HSB 177.) Effective date: 07/01/2023.
IA SF567
Replaced by
A bill for an act relating to health care services and financing including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums, and providing for licensee discipline.(Formerly SF 462, SSB 1167.)
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See SF 462, SF 567.)
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly HSB 177; See HF 685.)
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly SSB 1167; See SF 567.)
A bill for an act relating to health care services and financing, including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums. (Formerly HF 525, HSB 177.) Effective date: 07/01/2023.
A bill for an act relating to health care services and financing including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums, and providing for licensee discipline.(Formerly SF 462, SSB 1167.)
A bill for an act relating to eligibility for pregnant women and infants under the Medicaid program, and including effective date provisions.(See HF 2583.)
A bill for an act relating to the work without worry program for employed individuals with disabilities under the Medicaid program.(See HF 403, HF 2589.)
Extends right of Medicaid recovery in cases of third party liability for injury, illness, or death to Medicaid managed care organizations that provide covered services to Medicaid enrollees
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly HSB 177; See HF 685.)
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly SSB 1167; See SF 567.)
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See SF 462, SF 567.)
A bill for an act relating to health care services and financing, including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums. (Formerly HF 525, HSB 177.) Effective date: 07/01/2023.
A bill for an act relating to health care services and financing including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums, and providing for licensee discipline.(Formerly SF 462, SSB 1167.)
Extends right of Medicaid recovery in cases of third party liability for injury, illness, or death to Medicaid managed care organizations that provide covered services to Medicaid enrollees