MISSISSIPPI LEGISLATURE

2013 Regular Session

To: Appropriations

By: Representatives Frierson, Howell, Currie, Barker, Buck (5th), Dickson, Flaggs, Johnson, Mettetal, Turner, Warren, Watson

House Bill 1653

(As Passed the House)

AN ACT MAKING AN APPROPRIATION TO THE GOVERNOR'S OFFICE - DIVISION OF MEDICAID FOR THE PURPOSE OF PROVIDING MEDICAL ASSISTANCE UNDER THE MISSISSIPPI MEDICAID LAW AND DEFRAYING THE EXPENSES OF THE ADMINISTRATION OF SUCH LAW FOR THE FISCAL YEAR 2014.

     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1.  The following sum, or so much thereof as may be necessary, is hereby appropriated out of any money in the State General Fund not otherwise appropriated, to the Governor's Office - Division of Medicaid for the purpose of providing medical assistance under the Mississippi Medicaid Law and defraying the expenses of the administration of such law, as provided in Section 43-13-101 et seq., Mississippi Code of 1972, for the fiscal year beginning July 1, 2013, and ending June 30, 2014  

............................................ $   582,722,262.00.

SECTION 2.  The following sum, or so much thereof as may be necessary, is hereby appropriated out of any money in the State Treasury to the credit of the Medical Care Fund created by Section 43-13-143, Mississippi Code of 1972, for the purpose of providing medical assistance under the Mississippi Medicaid Law for the fiscal year beginning July 1, 2013, and ending June 30, 2014...........................................

.............................................. $ 420,052,225.00.

SECTION 3.  The following sum, or so much thereof as may be necessary, is hereby appropriated out of any money in any special fund in the State Treasury to the credit of the Governor's Office - Division of Medicaid which is comprised of special source funds collected by or otherwise available to the commission, for the purpose of providing medical assistance under the Mississippi Medicaid Law and defraying the expenses of the administration of such law, for the fiscal year beginning July 1, 2013, and ending June 30, 2014...... $ 4,319,718,467.00.

     Prior period recovery of funds may be maintained and expended by the division when the recovery is received or finalized.  Any recoveries due to audits or third party recoveries may be used to offset the cost of such audits and third party recoveries and as such, the division may escalate Contractual Services as needed for these purposes.

SECTION 4.  The following sum, or so much thereof as may be necessary, is hereby appropriated out of any money in the State Treasury to the credit of the Health Care Expendable Fund, for the purpose of defraying the expenses of the Governor's Office - Division of Medicaid for the fiscal year beginning July 1, 2013, and ending June 30, 2014.. $ 67,650,994.00.

     The above funds shall be allocated as follows:

CHIP Program at 200% level of poverty.... $    2,879,024.00

Eyeglasses for adults.................... $      699,191.00

Home and Community Waiver Program........ $    1,972,132.00

Disabled worker buy-in to the Medicaid

  program................................ $      754,715.00

Dental fee increase...................... $      904,837.00

Medical Program Matching Funds............ $  60,441,095.00

     It is the intention of the Legislature that funds may be shifted among the above allocated line items where needed in the discretion of the Executive Director of the Division of Medicaid.

SECTION 5.  Of the funds appropriated under the provisions of this act, the following positions are authorized:

  AUTHORIZED POSITIONS:

Permanent:    Full Time...........    1,027

Part Time...........        2

Time-Limited: Full Time...........       17

Part Time...........        0

     With the funds herein appropriated, it is the intention of the Legislature that it shall be the agency's responsibility to make certain that funds required to be appropriated for "Personal Services" for Fiscal Year 2015 do not exceed Fiscal Year 2014 funds appropriated for that purpose, unless programs or positions are added to the agency's Fiscal Year 2014 budget by the Mississippi Legislature.  Based on data provided by the Legislative Budget Office, the State Personnel Board shall determine and publish the projected annual cost to fully fund all appropriated positions in compliance with the provisions of this act.  It shall be the responsibility of the agency head to ensure that no single personnel action increases this projected annual cost and/or the Fiscal Year 2014 appropriations for "Personal Services" when annualized, with the exception of escalated funds.  If, at the time the agency takes any action to change "Personal Services," the State Personnel Board determines that the agency has taken an action which would cause the agency to exceed this projected annual cost or the Fiscal Year 2014 "Personal Services" appropriated level, when annualized, then only those actions which reduce the projected annual cost and/or the appropriation requirement will be processed by the State Personnel Board until such time as the requirements of this provision are met.

     Unless otherwise authorized in this act, no state agency shall take any action to promote or otherwise award salary increases through reallocation, reclassification, realignment, educational benchmark, career ladder, equity salary adjustment, or any other means to increase salaries of employees or positions unless specifically exempted by the following conditions:  the award of teacher salary increments; the advancement of a trainee/cadet to the next level of a bona fide career ladder; the award of an educational benchmark for the attainment of a Certified Public Accountant License or higher level professional certification; the immediate replacement of a departing employee with an employee from within state service at a salary level of the departing employee or the FY2014 promotional formula, whichever is less; the emergency appointment of nurses, pharmacists or other health care and child protection professionals at a salary to be determined by the State Personnel Board or any other requested action of the agency that has been specifically authorized by the Legislature.

     Any transfers or escalations shall be made in accordance with the terms, conditions and procedures established by law or allowable under the terms set forth within this act.  The State Personnel Board shall not escalate positions without written approval from the Department of Finance and Administration.  The Department of Finance and Administration shall not provide written approval to escalate any funds for salaries and/or positions without proof of availability of new or additional funds above the appropriated level.

     No general funds authorized to be expended herein shall be used to replace federal funds and/or other special funds which are being used for salaries authorized under the provisions of this act and which are withdrawn and no longer available.

     SECTION 6.  It is the intention of the Legislature that the Governor's Office - Division of Medicaid shall maintain complete accounting and personnel records related to the expenditure of all funds appropriated under this act and that such records shall be in the same format and level of detail as maintained for Fiscal Year 2013.  It is further the intention of the Legislature that the agency's budget request for Fiscal Year 2015 shall be submitted to the Joint Legislative Budget Committee in a format and level of detail comparable to the format and level of detail provided during the Fiscal Year 2014 budget request process with the Children's Health Insurance Program (CHIP) being separated from the Medical Services Program and submitted as a separate program.  In addition, the performance measures reported for the Medical Services Program shall include an unduplicated case count of individuals served by eligibility status, and the number and the costs of emergency room visits.

     SECTION 7.  In compliance with the "Mississippi Performance Budget and Strategic Planning Act of 1994," it is the intent of the Legislature that the funds provided herein shall be utilized in the most efficient and effective manner possible to achieve the intended mission of this agency.  Based on the funding authorized, this agency shall make every effort to attain the targeted performance measures provided below:

                                                          FY2014

Performance Measures                                      Target

Administrative Services

     Admin as a % of Total Budget (%)                       3.69

     Third Party Funds Recovered ($)               28,794,653.00

     Clean Claims % - 30 Days from Receipt (%)            100.00

     Clean Claims % - 90 Days from Receipt (%)            100.00

     Fiscal Agent Call Center Abandonment Rate (%)          1.90

     Fiscal Agent Call Center Avg Answer Time (%)          30.00

     Increase in Electronic Health Records              4,700.00

     Increase in E-Prescribing Technologies             4,700.00

     Providers Submitting Electronic Claims            22,000.00

     Third Party Liability Costs

          Avoided ($ in Thousands)                  1,268,019.00

     Applications Processed within

          Standard of Promptness (%)                       90.00

Medical Services

     Recipients Enrolled (Persons)                       668,069

     Emergency Room Visits ($)                     57,148,694.00

     Emergency Room Visits (Number of)                   381,364

     Out-stationed Eligibility Locations                     115

     Child Physical Exams                                262,634

     Adult Physical Exams                                  5,126

     Num of Fraud/Abuse Cases Investigated                   120

     Kidney Dialysis (Number of Trips)                    32,500

Child's Health Ins Prg (chip)

     CHIP Enrollees (Number of)                           72,667

     Out-stationed Eligibility Locations                  115.00

Home & Com Based Waiver Prg

     Elderly & Disabled - Persons Served                  17,300

     Elderly & Disabled - Funded Slots                    17,300

     Elderly & Disabled - Total Auth Slots                17,300

     Assisted Living - Persons Served                        585

     Assisted Living - Funded Slots                          605

     Assisted Living - Total Auth Slots                      700

     Independent Living - Persons Served                   2,600

     Independent Living - Funded Slots                     2,700

     Independent Living - Total Auth Slots                 4,200

     Traumatic Brain Inj - Persons Served                    850

     Traumatic Brain Inj - Funded Slots                      850

     Traumatic Brain Inj - Total Auth Slots                3,300

     Intellectual Disab - Persons Served                   2,000

     Intellectual Disab - Funded Slots                     2,000

     Intellectual Disab - Total Auth Slots                 3,200

     MYPAC - Persons Served                                  250

     MYPAC - Funded Slots                                    250

     MYPAC - Total Auth Slots                                250

     A reporting of the degree to which the performance targets set above have been or are being achieved shall be provided in the agency's budget request submitted to the Joint Legislative Budget Committee for Fiscal Year 2015.

     SECTION 8.  It is the intention of the Legislature that whenever two (2) or more bids are received by this agency for the purchase of commodities or equipment, and whenever all things stated in such received bids are equal with respect to price, quality and service, the Mississippi Industries for the Blind shall be given preference.  A similar preference shall be given to the Mississippi Industries for the Blind whenever purchases are made without competitive bids.

     SECTION 9.  Of the funds appropriated herein, an amount not to exceed Two Hundred Fifty Thousand Dollars ($250,000.00) is provided to implement an Adult Foster Care program for Medicaid recipients as authorized by Section 43-13-117, Mississippi Code of 1972.

     SECTION 10.  The division shall provide statistical and financial reports on a monthly basis to the Legislative Budget Office.  These reports shall include, but are not limited to, an accounting of all funds spent and participant statistics medical program, the CHIP program, the Dialysis Transportation program, and each of the Home-and-Community Based Waiver programs, and an accounting of all funds spent in the administrative program.

     The Division of Medicaid shall perform its cash flow projections on a predetermined monthly schedule and make this and any other information requested available, upon request, to the Chair of the Senate Public Health and Welfare Committee, the House Public Health and Human Services Committee, the House Medicaid Committee, the House and Senate Appropriations Committees as well as the Legislative Budget Office.

     SECTION 11.  Of the funds appropriated under the provisions of Section 3, One Hundred Twenty Million Four Hundred Ninety-three Thousand Five Hundred Sixty-six Dollars ($120,493,566.00) shall be derived from the Budget Contingency Fund created in Section 27-103-301, Mississippi Code of 1972, and allocated in a manner as determined by the Treasurer's Office.

     SECTION 12.  Of the funds appropriated in this act, the Division of Medicaid shall pay a per diem rate of reimbursement of no less than Fifty Dollars ($50.00) or more than Seventy-five Dollars ($75.00) to providers of adult day services for each day of service provided to an eligible beneficiary.  In order to receive this per diem rate of reimbursement, providers of adult day services shall participate in the Elderly and Disabled Waiver Program for Home and Community Based Services.

     SECTION 13.  In the division's Fiscal Year 2015 budget submission, all Medicaid 1915 (C) Home and Community Based Waivers shall be presented as a budget program separate from the Medical Services Program.

     SECTION 14.  The Division shall transfer One Million Dollars ($1,000,000.00) of State Support Funds to the Department of Rehabilitation Services for the expansion of the Independent Living Home and Community Based Waiver program and shall transfer One Million Dollars ($1,000,000.00) of State Support Funds to the Department of Human Services to expand the Home Delivered Meals program.

     SECTION 15.  Of the funds appropriated under the provisions of this act, Two Million Seven Hundred Fifty Thousand Dollars ($2,750,000.00) are provided for the purpose of funding a temporary program to provide nonemergency transportation to locations for necessary dialysis services for end-stage renal disease patients who are sixty-five (65) years of age or older or are disabled as determined under Section 1614(a)(3) of the federal Social Security Act, as amended, whose income did not exceed one hundred thirty-five percent (135%) of the nonfarm official poverty level as defined by the Office of Management and Budget and whose eligibility was covered under the former category of eligibility known as Poverty Level Aged and Disabled (PLADS).

     SECTION 16.  Of the funds appropriated under the provisions of Section 3, Sixty-nine Million Six Hundred Twenty-six Thousand Eighty-six Dollars ($69,626,086.00) shall be derived from the Working Cash-Stabilization Reserve Fund created in Section 27-103-203, Mississippi Code of 1972, and allocated in a manner as determined by the Treasurer's Office.

     SECTION 17.  Of the funds appropriated in Section 1 and 3, Three Hundred Ninety-eight Thousand Five Hundred Fifty Dollars ($398,550.00) General Funds and One Million One Hundred One Thousand Four Hundred Fifty Dollars ($1,101,450.00) Special Funds are provided for five (5) additional slots in the Assisted Living Waiver program for persons with Traumatic Brain Injury and in need of Cognitive Rehabilitation.  The Division shall develop eligibility criteria for these additional slots.

     SECTION 18.  The Division shall increase funding for the Assisted Living and Elderly and Disabled Home-and-Community Based Waiver programs by Three Million Dollars ($3,000,000.00).

     SECTION 19.  It is the intention of the Legislature that if enhanced federal funding for the modernization of Medicaid eligibility and enrollment IT systems necessary for the implementation of the Medicaid/CHIP Affordable Care Act may become available to the Division of Medicaid, the Division is authorized to escalate these funds in an amount not to exceed Fifty Million Dollars ($50,000,000.00) in accordance with procedures for federal fund escalations as established in Section 27-104-21, Mississippi Code of 1972, and expended for the purposes of performing such duties as set forth by law in accordance with applicable rules and regulations of the State Fiscal Officer.

     SECTION 20.  The money herein appropriated shall be paid by the State Treasurer out of any money in the State Treasury to the credit of the proper fund or funds as set forth in this act, upon warrants issued by the State Fiscal Officer; and the State Fiscal Officer shall issue his warrants upon requisitions signed by the proper person, officer or officers, in the manner provided by law.

     SECTION 21.  This act shall take effect and be in force from and after July 1, 2013.