Governor Mark Dayton Chair Michelle Benson 130 State Capitol 3109 Minnesota Senate Bldg
Total Page：16
File Type：pdf, Size：1020Kb
Governor Mark Dayton Chair Michelle Benson 130 State Capitol 3109 Minnesota Senate Bldg. 75 Rev. Dr. Martin Luther King Jr. Blvd. 95 University Ave. W. St. Paul, MN 55155 St. Paul, MN 55155 Sen. Tony Lourey (Minority Lead) Chair Matt Dean 2211 Minnesota Senate Bldg. 401 State Office Building 95 University Ave. W. 100 Rev. Dr. Martin Luther King Jr. Blvd. St. Paul, MN 55155 St. Paul, MN 55155 Rep. Erin Murphy (Minority Lead) 331 State Office Building 100 Rev. Dr. Martin Luther King Jr. Blvd. St. Paul, MN 55155 June 8, 2018 Dear Governor Dayton and Chairs Benson and Dean and Minority Leads Lourey and Murphy for the Health and Human Services Finance Committees: We are writing to express our serious concerns regarding several time-sensitive legislative requests left unresolved by the 2018 session. We believe there is significant, unfinished work that state lawmakers must address before the 2019 legislative session to protect the state budget, ensure continued access to care for some of Minnesota’s most vulnerable residents, and avoid unnecessary risk to our Medicaid program. Ensuring state agencies with programs, like Medicaid, are able to comply with federal law is a core component of state governance. From time to time, this requires approving necessary state investments and statutory changes to authorize state agencies to implement the ever-changing rules and regulations surrounding these programs and their funding streams. During the 2018 session, there were several proposals aimed at federal compliance for the state’s Medicaid program. Overall, they received strong bipartisan support, even though some of them did not come to light until late in the session. While we were pleased that the necessary adjustments and corrections passed the legislature, these solutions became victims of the more global and unrelated disputes regarding the omnibus supplemental budget package that was vetoed. The potential ramifications of leaving these key compliance issues unresolved this year could be significant, and their magnitude justifies special attention by state leaders. For example, ● Thousands of home-and-community-based providers who care for Minnesotans with disabilities will experience a 7 percent rate cut through the Disability Waiver Rate System on July 1, 2018 because existing state law was not clarified to ensure federal approval. Such a cut to a vital group of providers who already struggle with financial and workforce sustainability constitutes an insurmountable, and quite possibly unsustainable, burden on the system and these providers. ● Minnesota’s Medicaid program could lose up to $190 million a year in federal Medicaid matching funds for outpatient pharmacy payments because our law was not brought into compliance with a federal rule. Federal action to enforce the rule could create downstream vulnerability to Minnesota’s health care delivery system if federal Medicaid funds are withheld or retroactively recouped by the federal government due to this noncompliance. ● A change in the application of federal law has resulted in the loss of all federal Medicaid funds for residential treatment centers that provide critical mental and behavioral health services to children with complex needs. State funds are needed to fully fund this critical service through the final months of this biennium. A gap in both Medicaid and state funding for this critical service would further limit access to an already insufficient network of providers for children in need of these services and place a greater financial burden on counties to pick up the cost of these services. Without access to these services in Minnesota, even more children will be placed in out-of-state facilities making their recovery even more traumatic and difficult, and increasing the hardship on their families. If left unaddressed, any one of these three issues could have devastating consequences to the state’s budget and our health care system. Failing to remedy them and other issues related to federal compliance for Medicaid creates risks that are too great for the state to ignore. This is especially true when hundreds of millions of dollars are at risk of being lost unnecessarily -- dollars that would have otherwise been used to pay for health care services to Minnesotans. As organizations representing counties, hospitals and health systems, home and community- based services, mental health treatment providers, and the thousands of vulnerable Minnesotans who receive care through the state’s Medicaid program, we strongly urge you to find a way to take action prior to the 2019 legislative session on these issues and to mitigate any harm. Without such action, there could be lasting consequences to the sustainability of the state’s budget and the health of communities statewide. Sincerely, Lawrence J. Massa, M.S., FACHE Sue Abderholden, President & CEO MPH Minnesota Hospital Association Executive Director NAMI Minnesota Susan Morris Kirsten Anderson Isanti County Commissioner Executive Director President, Association of Minnesota Counties AspireMN Judy Marder, Chair, Best Life Alliance, cc: Senate Majority Leader Paul Gazelka Senate Minority Leader Tom Bakk House Speaker Kurt Daudt House Minority Leader Melissa Hortman Sen. Jim Abeler Sen. Jeff Hayden Rep. Joe Schomacker Rep. Tina Liebling Emily Johnson Piper, DHS Commissioner .