Medicaid expansion-2.

WORKING DRAFT
2014
STATE OF
WYOMING
14LSO-0381

HOUSE BILL
NO.

HB0161

Medicaid expansion
-2
.

Sponsored by:
Representative(s) Barlow

A BILL

for

AN ACT relating to Medicaid; providing for expansion of coverage to low income persons as specified; authorizing
negotiation for
a Medicaid demonstration waiver; providing waiver requirements as specified;
providing an appropriation;
and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1.

W.S. 42
‑
4
‑
401
and 42
‑
4
‑
402
are created to read:

ARTICLE 4
MEDICAID EXPANSION

42
‑
4
‑
401.

Medicaid expansion.

(a)

The
director of the
department
and
the
governor
shall
negotiate with the center for Medicare and Medicaid services of the United States department of health and human services for a demonstration waiver to provide Medicaid coverage effective
January
1, 2015,
for all persons

described under section 1902(a
)(
10)(A)(
i
)(VIII) of the
S
ocial Security Act, 42 U.
S.C. § 1396a(a)(10)(A)(
i
)(VIII).

(b)

Any expansion of Medicaid pursuant to this section shall be subject to the following:

(
i
)

Beneficiaries under the expansion waiver shall be United States citizens or
permanent resident
s
authorized by the United States citizenship and immigration services of the department of homeland security;

(ii)

Beneficiaries shall have been a resident of Wyoming for one (1) year prior to application;

(iii)

Beneficiaries shall be older than eighteen (18) years of age and less than sixty-five (65) years of age;

(iv)

Beneficiaries
shall be determined eligible through the federally operated health insurance exchange in Wyoming and shall not be eligible for any other governmental medical insurance program;

(v)

Each new beneficiary shall have an initiating health exam by a qualified physician;

(vi)

Health
care
shall be
delivered by:

(A)

Comprehensive care entities under contract with the department of healt
h, which shall include provider

led, insurer

led or manage
d
care organizations providing essential benefit healthcare services to eligible individuals and others on a regional or statewide basis; or

(B)

Premium payment assistance for employer based insurance for eligible recipients who are employed twenty (20) hours or more per week by an employer offering qualified health insurance.

(v
ii
)

Eligible participants may select and change their healthcare provider;

(viii)

Healthcare advocates may facilitate participant education
;

(ix)

The department shall ensure, and implement appropriate incentives to ensure, that there are comprehensive healthcare entities with an adequate provider network throughout the state;

(x)

The waiver plan shall include paymen
t models which are patient risk

a
djusted;

(xi)

Reimbursements to providers shall not be less than one hundred percent (100%) of the cost of care for healthcare providers who submit Medicare cost reports to the department;

(xii)

Cost sharing shall not be allowed for preventive healthcare services.

42
‑
4
‑
40
2
.

Medicaid expansion; federal funding contingency.

T
h
e program created by W.S. 42
‑
4
‑
401 and 42
‑
4
‑
40
2
shall not be administered during any time period in which t
he federal
medical assistance percentage,
as currently provided
pursuant to 42

U.S.C. § 1396d(y), is less than ninety percent (90%).

Section 2.

There is appropriated two hundred ten million dollars ($210,000,000.00) in federal funds to the department of health. This appropriation shall be for the period beginning with the effective date of this act and ending June 30, 2016. This appropriation shall only be expended for the purpose of Medicaid expansion as provided in this act. Notwithstanding any other provision of law, this appropriation shall not be transferred or expended for any other purpose and any unexpended, unobligated funds remaining from this appropriation shall revert as provided by law on June 30, 2016.

Section
3
.

This act is effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

1
HB0161