HB 2354 -- Medical Assistance Program

Sponsor:  Portwood

This bill changes the laws regarding medical assistance and
provider reimbursement.

MEDICAL ASSISTANCE FOR LOW-INCOME WORKERS

A medical assistance program is established for certain
individuals with a temporary disability or the parent of a minor
child.  Eligible individuals are required to:

(1)  Have earned income;

(2)  Meet certain asset limits;

(3)  Have net income that does not exceed the limit for permanent
and totally disabled individuals to receive nonspenddown MO
HealthNet Program benefits; and

(4)  Have a gross income of 250% or less of the federal poverty
level.

The bill specifies which types of income will be disregarded when
determining an individual's net income.  Individuals with an
income above 100% of the federal poverty level will be required
to pay a percent of their income as a premium for participation
in the program.  Participants are required to report any change
in income or household size within 10 days of the change.  If a
participant has access to employer-sponsored health insurance and
the Department of Social Services determines that it is more cost
effective, the department must pay the participant's portion of
the premiums, co-payments, and other associated costs for
participation in the employer-sponsored health insurance.  The
department is required to obtain any necessary waivers or state
plan amendments to obtain the federal funding necessary to
provide medical assistance.

ENHANCED PROVIDER REIMBURSEMENTS

Providers under the program are allowed to receive enhanced
reimbursement for certain services.  The enhanced rate will be
120% of the federal Medicare reimbursement rate for new patients
and 110% for established patients.  In order to qualify for the
enhanced reimbursement, the provider must:

(1)  Become the health care home for a patient;

(2)  Complete a patient history and consultation for the patient;
and

(3)  File a treatment plan for the patient.

The provisions regarding medical assistance for low-income
workers will expire six years from August 28, 2008.

Missouri House of Representatives
94th General Assembly, 2nd Regular Session
Last Updated October 15, 2008 at 3:12 pm