April 9, 2002
TO THE MISSISSIPPI STATE SENATE:
GOVERNOR'S
VETO MESSAGE FOR SENATE BILL 2189
I am returning Senate Bill Number
2189: "AN ACT TO AMEND SECTION
43-13-117, MISSISSIPPI CODE OF 1972, AS AMENDED BY HOUSE BILL NO. 1200 AND
SENATE BILL NO. 3060, 2002 REGULAR SESSION, TO AUTHORIZE UNLIMITED DAY
REIMBURSEMENT FOR DISPROPORTIONATE SHARE PROGRAM HOSPITALS FOR ELIGIBLE
CHILDREN UNDER THE AGE OF SIX ONLY IF CERTIFIED AS MEDICALLY NECESSARY; TO
AUTHORIZE A JOINT LEGISLATIVE STUDY COMMITTEE TO CONSIDER THE ISSUE OF SETTING
UNIFORM REIMBURSEMENT RATES FOR NURSING HOMES; TO DELETE SPECIFIC FEE INCREASES
FOR PERIODIC SCREENING AND DIAGNOSTIC SERVICES; TO DIRECT THE DIVISION TO
ESTABLISH A CLOSED DRUG FORMULARY; TO PROVIDE THAT THE MONTHLY LIMIT ON PRESCRIPTION
DRUGS DOES NOT APPLY TO INSTITUTIONALIZED RECIPIENTS; TO PROVIDE THAT THE PRIOR
APPROVAL REQUIREMENT FOR PRESCRIPTIONS ABOVE A CERTAIN NUMBER APPLIES TO ALL
RECIPIENTS; TO AUTHORIZE MEDICAID REIMBURSEMENT FOR MENTAL HEALTH SERVICES
PROVIDED IN THE COMMUNITY BY A FACILITY OR PROGRAM OPERATED BY THE DEPARTMENT
OF MENTAL HEALTH; TO REVISE THE CONDITIONS FOR REIMBURSEMENT OF THE COST OF
EYEGLASSES FOR RECIPIENTS; TO CLARIFY THE REQUIREMENT FOR DISPROPORTIONATE
SHARE PROGRAM HOSPITALS TO PARTICIPATE IN THE FEDERAL INTERGOVERNMENTAL
TRANSFER PROGRAM; TO AUTHORIZE THE DIVISION OF MEDICAID TO ESTABLISH A MEDICARE
UPPER PAYMENT LIMITS PROGRAM FOR NURSING FACILITIES; TO CHANGE CERTAIN
REFERENCES TO THE FEDERAL INDIVIDUALS WITH DISABILITIES EDUCATION ACT; TO AUTHORIZE
MEDICAID REIMBURSEMENT TO RURAL HEALTH CENTERS FOR AMBULATORY SERVICES; TO
AUTHORIZE FUNDS TRANSFERRED TO THE DEPARTMENT OF MENTAL HEALTH BY A POLITICAL
SUBDIVISION OR INSTRUMENTALITY OF THE STATE TO BE USED AS MEDICAID MATCH FOR
REIMBURSEMENT OF HOME- AND COMMUNITY-BASED SERVICES FOR DEVELOPMENTALLY
DISABLED PEOPLE; TO AUTHORIZE MEDICAID REIMBURSEMENT TO CHIROPRACTORS FOR
X-RAYS PERFORMED TO DOCUMENT CONDITIONS; TO AUTHORIZE THE DIVISION TO APPLY FOR
FEDERAL WAIVERS THAT MAY ENHANCE THE POPULATION HEALTH MANAGEMENT PROGRAM; TO
PROVIDE MEDICAID REIMBURSEMENT FOR PEDIATRIC LONG-TERM ACUTE CARE HOSPITAL
SERVICES; TO EXEMPT NONEMERGENCY TRANSPORTATION SERVICES FROM THE REQUIREMENT
FOR A COPAYMENT; TO PROVIDE THAT THE FIVE PERCENT REDUCTION IN PROVIDER REIMBURSEMENTS
IMPOSED BY HOUSE BILL NO. 1200, 2002 REGULAR SESSION, SHALL NOT APPLY TO THOSE
HEALTH CARE FACILITIES UPON WHICH AN ASSESSMENT IS LEVIED UNDER SECTION
43-13-145, MISSISSIPPI CODE OF 1972; TO PROVIDE THAT THE FIVE PERCENT REDUCTION
ALSO SHALL NOT APPLY TO CERTAIN SERVICES PROVIDED BY PLANNING AND DEVELOPMENT
DISTRICTS IF THE DISTRICTS TRANSFER CERTAIN SUMS TO THE DIVISION; TO AMEND
SECTION 43-13-121, MISSISSIPPI CODE OF 1972, TO CLARIFY AND REVISE THE
CONDITIONS FOR DENYING OR REVOKING PROVIDER ENROLLMENT IN THE MEDICAID PROGRAM;
TO AMEND SECTION 43-13-123, MISSISSIPPI CODE OF 1972, TO CLARIFY THAT THE
DIVISION SHALL OBTAIN SERVICES IN ACCORDANCE WITH REGULATIONS OF THE PERSONAL
SERVICE CONTRACT REVIEW BOARD; TO AMEND SECTION 43-13-127, MISSISSIPPI CODE OF
1972, TO REQUIRE THE DIVISION OF MEDICAID TO SUBMIT A MONTHLY REPORT TO THE
CHAIRMEN OF THE SENATE AND HOUSE PUBLIC HEALTH AND WELFARE COMMITTEES AND TO
THE JOINT LEGISLATIVE BUDGET COMMITTEE; TO AMEND SECTION 43-13-145, MISSISSIPPI
CODE OF 1972, TO INCREASE THE MEDICAID ASSESSMENT ON NURSING HOME BEDS AND
PROVIDE FOR MEDICAID ASSESSMENTS ON OTHER HEALTH CARE FACILITIES; TO PROVIDE
FOR THE COLLECTION OF THOSE ASSESSMENTS; TO AMEND SECTION 41-7-191, MISSISSIPPI
CODE OF 1972, TO PROVIDE THAT THE ADDITION OR CONVERSION OF ANY NUMBER OF BEDS
OF A HEALTH CARE FACILITY SHALL REQUIRE APPROVAL BY A CERTIFICATE OF NEED; TO
DIRECT THE STATE DEPARTMENT OF HEALTH TO TRANSFER A CERTAIN CERTIFICATE OF NEED
AUTHORIZING PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY BEDS IN WARREN COUNTY;
AND FOR RELATED PURPOSES" without my approval, and assign the following
reasons for my veto.
I hereby veto Senate Bill No. 2189
that makes technical amendments to the laws governing the Division of Medicaid
because it compounds and complicates the existing problems with the funding and
administration of this agency.
Although this bill is adopted in
the name of achieving savings in the Medicaid program, there are several
instances where private and special interests prevail to unnecessarily increase
the costs of the program. Examples include the failure to freeze the
certification of new expensive nursing home beds for Medicaid while there
exists unused capacity; the potential cost to the program is over $6 million
from the State General Fund. Additionally, certification for less expensive
expansion of existing facilities is capped at 10% while there is no limit on
new, expensive construction.
Also, co-payments on non-emergency
transportation for Medicaid recipients to offset transportation costs were
eliminated, depriving the Division of the means to gain control of expenses.
There is true need for a more cost effective prescription drug program, but
the closed formulary approach, while well intentioned, is legally
questionable.
These are only three instances in
Senate Bill No. 2189 of expensive micromanagement of a complex, $2.5 billion
agency. Growth of the program is not curbed but expanded, and in unnecessary
ways. More specific mandates are imposed on the Division instead of the flexibility
to allocate resources to greatest need. This is exactly backwards. The flaws in
this bill mirror the inadequacies of House Bill No. 1794, the appropriation
bill for the Medicaid Division, and they should both be reconsidered together.
I urge the members to sustain the
veto and reject Senate Bill No. 2189.
Respectfully submitted,
RONNIE MUSGROVE
GOVERNOR