{"id":35607,"date":"2024-02-16T12:52:32","date_gmt":"2024-02-16T18:52:32","guid":{"rendered":"http:\/\/update.legislature.ne.gov\/?p=35607"},"modified":"2024-02-16T12:52:32","modified_gmt":"2024-02-16T18:52:32","slug":"hospital-assessment-program-clears-first-round","status":"publish","type":"post","link":"https:\/\/update.legislature.ne.gov\/?p=35607","title":{"rendered":"Hospital assessment program clears first round"},"content":{"rendered":"

A bill intended to increase Medicaid payments to Nebraska hospitals without the use of additional general fund dollars was amended and advanced to select file Feb. 15.<\/p>\n

\"Sen.
Sen. Mike Jacobson<\/figcaption><\/figure>\n

LB1087, introduced by North Platte Sen. Mike Jacobson, would require the state Department of Health and Human Services to submit a state plan amendment to the Centers for Medicare and Medicaid Services for approval to impose an assessment on Nebraska hospitals.<\/p>\n

Under the plan, each Nebraska hospital would pay an assessment fee based on their quarterly net patient revenue. The total statewide assessment amount could not exceed 6% of the total net patient revenue of all assessed hospitals.<\/p>\n

Jacobson said the bill would allow Nebraska to access a federal program used by 43 other states and the District of Columbia that provides matching funds to help hospitals cover the cost of treating individuals on Medicaid.<\/p>\n

For each dollar assessed under the program, he said, the federal match in Medicaid directed payments would be approximately $2.19 \u2014 a total of approximately $1 billion per year. Those dollars would be distributed to Nebraska hospitals based on their share of Medicaid patients treated in both inpatient and outpatient settings.<\/p>\n

The majority of Nebraska hospitals are losing money on operations, Jacobson said, including 59% of small, rural critical access hospitals. Several of those hospitals have closed labor and delivery units, hospital-owned nursing homes and behavioral health, hospice and home health services, he said.<\/p>\n

\u201c[LB1087] presents a lifeline to Nebraska hospitals and the people they serve,\u201d Jacobson said. \u201cIf passed, this bill would increase and improve access to quality care across the state and give us measurable results for all Nebraskans.\u201d<\/p>\n

A Health and Human Services Committee amendment, adopted 39-0 replaced the bill. The contents of that amendment were in turn replaced by an amendment offered by Jacobson and adopted 34-3.<\/p>\n

As amended, LB1087 would be administered by DHHS, which would receive an administration fee of 3% of the assessment amount, not to exceed $15 million. Of the total assessed amount, 3.5% could be used for health priorities including funding non-hospital Medicaid rates for physicians, dental care, behavioral health services or increased rates for nursing homes, among other priorities. That amount would be capped at $17.5 million annually.<\/p>\n

The amendment also would eliminate the bill\u2019s original fiscal note of more than $400 million by changing the timing mechanism for how Medicaid directed payments would be paid to the state\u2019s hospitals and would terminate the program Dec. 31, 2026.<\/p>\n

Jacobson said the termination provision was part of a negotiation between the state\u2019s hospitals and the executive branch.<\/p>\n

Several lawmakers, including Sen. Myron Dorn of Adams, expressed concerns about the sunset date, noting that it might not provide the state enough time to establish such a complex program and have sufficient data to evaluate it properly.<\/p>\n

\u201cWhen we set in motion a program like this, especially \u2026 a Medicaid program, it\u2019s not one where tomorrow we turn a switch on [and] now it\u2019s up and going,\u201d Dorn said. \u201cIt\u2019s going to take time.\u201d<\/p>\n

Sen. Danielle Conrad of Lincoln echoed those concerns when explaining her vote against the Jacobson amendment. She said she strongly supported the underlying bill \u2013 calling it a \u201ccommonsense\u201d solution to the challenges facing the state\u2019s hospitals \u2013 but warned against ceding control over programs that the Legislature creates by giving \u201ctoo much deference\u201d to the executive branch.<\/p>\n

\u201c[The amendment] unnecessarily and needlessly weakens a really smart, strong policy solution that essentially there is very, very strong support for,\u201d Conrad said.<\/p>\n

Jacobson agreed with those concerns, but said the sunset provision was negotiated \u201cin good faith\u201d and that he intended to keep his word.<\/p>\n

\u201cDo I agree with the sunset? No,\u201d he said.<\/p>\n

Sen. Ben Hansen of Blair supported the sunset provision. States rarely discontinue a program once it\u2019s established, even if the federal government alters program requirements in ways that lawmakers disagree with, he said.<\/p>\n

\u201cI\u2019ll bet the farm on it that \u2026 we\u2019re not going to give up that money,\u201d Hansen said. \u201cThis is a growing concern I\u2019ve had for the six years that I\u2019ve been here.\u201d<\/p>\n

Following adoption of the amendments, lawmakers voted 40-0 to advance LB1087 to select file.<\/p>\n","protected":false},"excerpt":{"rendered":"

A bill intended to increase Medicaid payments to Nebraska hospitals without the use of additional general fund dollars was amended and advanced to select file Feb. 15.<\/p>\n","protected":false},"author":1,"featured_media":35554,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"colormag_page_container_layout":"default_layout","colormag_page_sidebar_layout":"default_layout","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[12],"tags":[284],"class_list":["post-35607","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-and-human-services","tag-sen-mike-jacobson"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/update.legislature.ne.gov\/wp-content\/uploads\/2024\/02\/LB1087Jacobson2-15-24a.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/35607","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=35607"}],"version-history":[{"count":2,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/35607\/revisions"}],"predecessor-version":[{"id":35609,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/posts\/35607\/revisions\/35609"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=\/wp\/v2\/media\/35554"}],"wp:attachment":[{"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=35607"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=35607"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/update.legislature.ne.gov\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=35607"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}