Recent Legislative Activity - Reimbursement

2008
Reimbursement reduction for prisoner health care
(stricken by patron)
HB 1273 – Del. Lionell Spruill, Sr.
Would have required that payment by local and state correctional facilities for costs incurred for health care for prisoners not exceed the lesser of the amount that would be paid under Medicare or Medicaid.  If passed, this bill would have taken millions from physicians, hospitals and other health care providers.

Health care cost transparency reporting
HB 603 - Del. John O’Bannon III, MD
SB 396 - Sen. John Edwards
Requires the State Health Commissioner to negotiate and contract with Virginia Health Information (VHI) for an annual survey of carriers offering private group health insurance policies and that are subject to HEDIS reporting, to determine the reimbursement that is paid for a minimum of 25 most frequently reported health care services, and to make the survey reports public through a Website operated by VHI. This bill also requires carriers to report the average reimbursement paid for a specific service from all providers and provider types

2007
Medicaid Budget

• All physicians providing pediatric services received a 10 percent increase (included the eight percent Increase passed in 2006 and the two percent increase passed in 2007).
• All other physicians will receive a five percent increase (included the three percent increase passed in 2006 and the two percent increase passed in 2007).
• Eligibility requirements to provide Medicaid benefits to pregnant women increased from 150 percent of the federal poverty level to 185 percent.

HB 3188 – Del. Mark Sickles
Electronic Medicaid Reimbursement
As originally introduced, HB 3188 would have mandated that the Department of Medical Assistance Services (DMAS) provide all Medicaid payments to providers electronically. MSV worked with Del. Sickles to favorably amend the bill to encourage physicians to accept electronic payment when feasible without mandating such an arrangement for practices that continue to file paper claims.

Reimbursement reduction for physicians providing prisoner health care
HB 2034 – Del. Phillip Hamilton
The legislation would have required that payment by local and state correctional facilities for costs incurred for health care for prisoners not exceed the lesser of the amount that would be paid under Medicare or Medicaid. Under current law, physicians and hospitals can negotiate rates directly with local and state correctional facilities. If passed, this legislation would have taken millions from physicians, hospitals and other health care providers. MSV worked closely with Virginia hospitals and health care lobbyists to lobby against HB 2034.  HB 2034 was stricken at the request of Del. Hamilton.

2006
Medicaid reimbursement
The 2006-2008 biennium budget included Med­icaid reimbursement increases for almost all physi­cians.

All physicians received a three percent increase on July 1, 2007 as a result of the 2006-2008 budget.

• The increase did not apply to OB-Gyns, who received a 34 percent increase in 2004.
• Increases for pediatric services (applies to pa­tients up to age 21 enrolled in Medicaid and FAM­IS; pediatric services rendered in emergency rooms were excluded):
  • All physicians providing pediatric services re­ceived a five percent increase on May 1, 2006.
  • All physicians providing pediatric services re­ceived a five percent increase on July 1, 2006.
  • All physicians providing pediatric services received a five percent increase on July 1, 2007.
• The General Assembly also allocated funding to provide Medicaid benefits to pregnant women who earn up to 166 percent of the federal poverty level.