HB 1235: Updates to Medicaid

On or before December 1, 2026, and annually thereafter, the act requires each transportation broker that administers nonemergency medical transportation to medicaid members to submit certain information to the department of health care policy and financing (state department) regarding transportation providers that the transportation broker contracts with. Beginning January 1, 2027, the state department is required to include this information in its annual 'SMART Act' presentation. The act changes the term 'qualified alien' to 'qualified noncitizen' to align with federal requirements. If the state department plans to implement, apply, or enforce new multiple procedure payment reductions for outpatient therapy services, the act requires the state department to provide notice to the impacted providers of the changes at least 6 months prior to implementing the changes and to hold at least one stakeholder meeting to discuss the payment reductions. The act requires the state department to reimburse a provider who is licensed and authorized to prescribe, dispense, compound, or administer medication-assisted treatment in a jail setting. The act requires the medical services board to adopt rules before January 1, 2027, to comply with federal community engagement requirements and requires the state department make available on its website data on the community engagement requirements and their impact on medical assistance enrollment. The act requires the state department to collect direct care service cost to administrative cost ratio information from home- and community-based service provider agencies and submit a report to the general assembly detailing the information collected. The act repeals the state medical assistance and services advisory council.(Note: This summary applies to this bill as enacted.)