Missouri set to reform Medicaid, boost doctor pay

Legislation would provide $25 million to increase reimbursement and calls for health improvement plans for the 825,000 Medicaid enrollees.

By Doug Trapp, AMNews staff. June 25, 2007.

Washington -- Missouri physicians' Medicaid payment rates would climb a little now and maybe a lot later under legislation passed by the General Assembly last month.

The fiscal year 2008 state budget bill includes $25 million to increase Medicaid physician payments from about 44% to 55% of Medicare rates.

Also, a comprehensive Medicaid reform bill would require the state's Medicaid agency to create a plan to raise Medicaid pay to match Medicare rates by 2012. About $86 million more is needed to achieve that goal.

The budget and Medicaid bills were still being reviewed by Missouri Gov. Matt Blunt. Tom Holloway, director of governmental relations for the Missouri State Medical Assn., said Blunt is expected to sign them because the governor championed Medicaid reform. Blunt has until July 14 to decide. The MSMA supported the Medicaid increase but did not take a position on the reform bill.

The Medicaid measure is expected to cost between $178.5 million and $287.9 million, said Jim Uffman, interim director of the Missouri Dept. of Social Services' budget division.

Medicaid reform has been a back-and-forth issue in Missouri. Legislation adopted by the General Assembly in 2005 created a Medicaid reform commission and required lawmakers to reauthorize the state's Medicaid program by June 30, 2008. Missouri has about 825,000 Medicaid enrollees, including 484,000 in the State Children's Health Insurance Program.

The new bill satisfies the reauthorization requirement. But 2005 eligibility cutbacks and re-qualification requirements for enrollees shrunk the program by about 95,000, said Sara Anderson, Missouri Dept. of Social Services spokeswoman. In a sense, this year's reforms are expected to reverse that loss by adding about 98,000 people to Medicaid and SCHIP, mostly through the addition of about 82,000 enrollees to a health program for uninsured women.