Medicaid Mental Health Reimbursement Rates Report

The act requires the department of health care policy and financing (department) to prepare a behavioral health rates report of medicaid reimbursement rates for community mental health providers and independent mental health and substance use treatment providers. The department shall hire an independent auditor to prepare the behavioral health rates report. The department shall, in coordination with the behavioral health rates report, prepare recommendations to create equitable payment models between providers of community mental health centers and independent mental health and substance use treatment providers providing comparable behavioral health services. The department shall present the behavioral health rates report and recommendations to the house of representatives public and behavioral health and human services committee.

The audit conducted must reflect data from state fiscal year 2020-21 and include a determination and recommendations on the adequacy of reimbursement rates paid to medicaid mental health providers. The department shall present an action plan to implement changes to reimbursement rates based on the findings of the audit to the joint budget committee before November 15, 2022. The department shall also prepare an annual progress report on the state's progress in implementing the action plan and provide an update at the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing on or before August 1, 2023, and annually thereafter through August 1, 2025. The act requires the department to fully implement the action plan no later than December 31, 2025.

The department shall publish an annual cost report on or before March 15, 2023, and each year thereafter. The department shall establish a cost report template and cost reporting schedule to assist community mental health centers in relaying cost information to the state department. The department shall establish a transparency report that translates the cost report data into meaningful and actionable information to ensure equity in provider compensation and adequate access to care for medicaid members. The department shall redact certain information from the cost reports to ensure compliance with state and federal privacy laws. The department shall create a publicly accessible website providing information on the behavioral health rates reports and information to assist the public, medicaid providers, and medicaid members in understanding the published information.

(Note: This summary applies to this bill as enacted.)