Senate Concurrent Resolution 538

A CONCURRENT RESOLUTION DIRECTING THE SENATE MEDICAID COMMITTEE AND THE HOUSE MEDICAID COMMITTEE TO CONDUCT A JOINT STUDY AND EVALUATION TO DEVELOP AND MAKE RECOMMENDATIONS CONCERNING THE GROWTH IN STATE SPENDING FOR THE MISSISSIPPI MEDICAID PROGRAM; TO DIRECT THE JOINT COMMITTEE TO MAKE A WRITTEN REPORT OF ITS FINDINGS AND RECOMMENDATIONS BEFORE DECEMBER 1, 2017; AND FOR RELATED PURPOSES.

WHEREAS, during the 2016 meetings of legislative working groups formed by the Speaker of the House of Representatives and Lieutenant Governor to look at the state's revenue collections and expenditure, the Division of Medicaid reported that the program has grown from $763 Million in state funds in fiscal year 2012 to at least $948.6 Million for the current fiscal year; and

WHEREAS, Republican Presidential-elect Donald Trump has suggested that his healthcare reform plan would give states "block grants" to manage the Medicaid Program because "state governments know their people best and can manage the administration of Medicaid far better without federal overhead." Under the preliminary healthcare reform proposal, states will have the incentives to seek out and eliminate fraud, waste and abuse to preserve precious resources. An unprecedented number of states are also contracting the administration of benefits to private health insurers as a way to save money or bring private technology and claims administration to a government program. Decisions to involve commercial insurers in Medicaid are state decisions; and

WHEREAS, in 1995 the Legislature amended the Mississippi Medicaid Law to direct the Division of Medicaid to design and implement a program of capitated managed care for Medicaid recipients. Proponents of capitated managed care say that it will control medical costs, which for many years have been increasing at rates well above the overall inflation rate. It is the opinion of many that utilizing capitated managed care to provide Medicaid services, especially in rural areas where there are fewer health care providers, will be the most far-reaching change in the Medicaid program since it began in Mississippi in 1969; and

WHEREAS, the funding formulas currently set forth by the Division of Medicaid are inequitable when administered on a statewide basis; and

WHEREAS, it has been suggested that the Division of Medicaid Fraud Control Unit assist the Division of Medicaid in implementing program integrity and the prevention and detection of fraud and abuse in the Medicaid program, the Medicaid managed care program and the Children's Health Insurance Program (CHIP); and

WHEREAS, in anticipation of the automatic repeal of the Medicaid authorized services statute (Section 43-13-117, Mississippi Code of 1972) on July 1, 2018, and the health care facilities Medicaid assessments statute (Section 43-13-145, Mississippi Code of 1972) on July 1, 2018, it is incumbent upon the Legislature to study and evaluate the future of the Mississippi Medicaid Program at least one year in advance of the automatic repealers; and

WHEREAS, for these reasons, it is the determination of the Legislature that the Medicaid Committees of the Senate and House should meet jointly to make recommendations concerning the following: (a) the growth in state spending for the Mississippi Medicaid Program; (b) the capitated managed care for Medicaid recipients; (c) the implementation of program integrity and fraud abuse in the Medicaid Program; (d) the funding formulas used by the Division of Medicaid, the Medicaid Managed Care Program and the Children's Health Insurance Program (CHIP); and (e) to evaluate the Medicaid Program in light of Congress' expected action on the Affordable Care Act:

NOW, THEREFORE, BE IT RESOLVED BY THE SENATE OF THE STATE OF MISSISSIPPI, THE HOUSE OF REPRESENTATIVES CONCURRING THEREIN, That the Medicaid Committee of the Mississippi Senate and the Medicaid Committee of the Mississippi House of Representatives, meeting jointly, is hereby authorized and directed to study, develop and make recommendations concerning the following: (a) the growth in state spending for the Mississippi Medicaid Program; (b) the capitated managed care for Medicaid recipients; (c) the implementation of program integrity and fraud abuse in the Medicaid Program; (d) the funding formulas used by the Division of Medicaid, the Medicaid Managed Care Program and the Children's Health Insurance Program (CHIP); and (e) to evaluate the Medicaid Program in light of Congress' expected action on the Affordable Care Act.

The Chairman of the Senate Medicaid Committee and the Chairman of the House Medicaid Committee shall serve as co-chairmen of the joint committee. Within fifteen (15) days after sine die adjournment of the 2017 Regular Session of the Legislature, the joint committee shall meet on a date designated by the co-chairmen of the joint committee in Jackson, Mississippi, to organize the committee and establish rules for transacting its business and keeping records. A majority of the members of the joint committee from each house shall constitute a quorum at all committee meetings. An affirmative vote of a majority of the members from each house shall be required in the adoption of rules, resolutions and reports. All members of the joint committee shall be notified in writing of all regular and special meetings of the committee, which notices shall be mailed at least five (5) days before the dates of the meetings.

The joint committee may establish any subcommittees that it deems desirable to study and report to the committee with respect to any matter that is within the scope of this resolution.

The joint committee shall make a written report of its findings and recommendations, and shall mail copies of the report to each member of the Legislature not later than December 1, 2017. After the report is made, the joint committee shall continue in existence as an oversight committee to monitor the Medicaid Program on an ongoing basis.

In carrying out the provisions of this resolution, the joint committee may utilize the services, facilities and personnel of all departments, agencies, offices and institutions of the state, including the state universities and the community and junior colleges. The joint committee shall, at a minimum, receive testimony and written recommendations from Mississippi managed care organizations, the Mississippi State Medical Association, representatives of skilled nursing facilities and the Division of Medicaid, Office of the Governor, in making its determination. In particular, the joint committee shall consult with the Division of Medicaid, and the Division of Medicaid shall cooperate with the committee and provide the committee with any information and other assistance requested by the committee. The joint committee may consult and seek advice from various groups in the state in order to understand the effect of any existing laws or any changes in law being considered by the Legislature.

For attending meetings of the joint committee, each member shall be paid from the contingent expense fund of the member's respective house, per diem compensation in the amount authorized by Section 25-3-69 and a mileage allowance and an expense allowance in the amount authorized by Section 5-1-47. However, no per diem compensation, mileage allowance or expense allowance shall be paid for attending meetings of the joint committee while the Legislature is in session, and no per diem compensation, mileage allowance or expense allowance shall be paid without prior approval of the proper committee in the member's respective house.

All expenses incurred by and on behalf of the joint committee shall be paid from funds made available by the House Management Committee and the Senate Rules Committee from the contingent expense funds of the respective houses, from any funds appropriated for the purpose of this resolution, and from any grants or contributions made to the committee for its purpose.