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Social services, health departments propose streamlining Medicaid compliance process

  

JEFFERSON CITY, Mo. — The leaders of Missouri’s social services and health departments said they are working on a plan to change how Medicaid provider compliance issues are dealt with in an effort to streamline the process. 

Department of Social Services (DSS) Acting Director Jennifer Tidball and Department of Health and Senior Services (DHSS) Acting Director Robert Knodell said they were working on a way to cut back on potential duplicative efforts when issues of compliance arrive. While the majority of MO HealthNet, Missouri’s Medicaid program, is housed under DSS, the health department does oversee some providers as well as licensures for abortion providers. 

The proposed change would allow DSS to accept the findings and sanctions brought against a provider by DHSS and act accordingly, the directors said. As it stands now, DHSS sends its information regarding sanctions to DSS and a division under that department conducts its own investigation. 

“The purpose of that [proposed] regulation is just to reduce the time that it would take for us to take action on providers to ensure the health, safety, and wellbeing of Missouri citizens who receive services through the Medicaid program. We just want to make sure all of our providers are qualified and capable providers,” Tidball said. “I think this just enhances that partnership between our two departments on making sure that we’re making that happen in the Medicaid program.” 

Due process protections for providers would remain in place, both officials said. 

Knodell and Tidball appeared before the Senate Interim Committee on Medicaid Accountability and Taxpayer Protection for an hour-long hearing Tuesday afternoon. The committee is holding hearings over the interim regarding the MO HealthNet program and funding to abortion providers and affiliates. 

The creation of the committee came after conservative legislators were angered that legislation stripping Planned Parenthood and its affiliates of Medicaid funding failed to make it through a special session last month. 

While no official plans were unveiled Tuesday regarding the promulgation of new rules specifically addressing Planned Parenthood and its affiliates yet, Knodell said the department is open to a “collaboration” with the committee should future requests be made. 

“We’ve had discussions with a number of senators who are looking to ensure the health and safety of Medicaid recipients as it relates to services they may receive at an abortion facility — which we inspect and regulate at DHSS,” Knodell said. 

Sen. Bill White, who chairs the interim committee, pointed to a 2016 Centers for Medicare and Medicaid Services (CMS) memo allowing states to “establish qualification standards or take certain actions” against a provider when its capability to perform services in a “safe, legal, and ethical manner” is in question. White argued the “ethical” portion could give the committee fodder to request more rules since Missouri “is a very pro-life state.” 

Missouri’s Medicaid dollars paid for only 25 abortions between October 2015 and June 2021, Tidball testified. Every instance was when the life of the mother was at stake, she said. It was not immediately clear if the abortions occurred at hospitals or Planned Parenthood.  

The next hearing of the Senate Interim Committee on Medicaid Accountability and Taxpayer Protection, allowing for public commentary, is tentatively scheduled for Aug. 4. White asked senators to consider a myriad of topics to study while the committee meets, from funding issues to managed care to a potential upgrade of the Medicaid Management Information System. 

Sen. Karla Eslinger, the vice chair of the committee, implored the group to also look at the lack of physicians who will take Medicaid patients, including children, in certain rural parts of the state such as her district in southern Missouri. 

“I just want to say publicly — and to applaud, frankly — the opportunity for this committee to be able to look into these kinds of issues but then also … to be able to do something that really will do what our mission has been and that is to stop all abortions,” Eslinger said. 

Aside from White and Eslinger, other members of the committee include Sens. Lauren Arthur, Mike Bernskoetter, Justin Brown, Mike Cierpiot, Bill Eigel, Elaine Gannon, Karla May, and Jill Schupp. In announcing the creation of the committee, Senate GOP leadership said it would be tasked with the “continued protection of unborn life.”