HB0064 Enhanced Medicaid reimbursement rate-maternal services. |…

Enhanced Medicaid reimbursement rate-maternal services.

AN ACT relating to medical assistance and services; authorizing the department of health to apply for enhanced Medicaid reimbursement for eligible providers of maternal services; providing definitions; providing purposes for enhanced reimbursement rates; requiring reports; providing appropriations; requiring rulemaking; and providing for effective dates.

Plain English Breakdown

It is unclear whether the allocation of funds over two years is accurate as the bill specifies only one year, but it's possible this is a typo or an omission.

Enhanced Medicaid Reimbursement for Maternal Services

This act allows the Department of Health to apply for higher Medicaid payments for eligible healthcare providers offering maternal health services in rural and frontier areas, with goals to improve access to prenatal, intrapartum, and postpartum care.

What This Bill Does

Allows the Wyoming Department of Health to request federal approval for increased Medicaid payment rates for eligible healthcare providers offering maternal health services.

Defines 'eligible provider' as a healthcare professional who is enrolled in Medicaid, has relevant privileges at a labor and delivery facility, and holds specific medical licenses such as obstetrician-gynecologist or family physician providing obstetrical services, midwife, general surgeon providing cesarean section backup, or any other health care provider as determined by rules set by the department.

Specifies that 'rural and frontier areas' will be determined by the Department of Health based on federal guidelines.

Requires the Department to report to state committees about costs and recommendations for changes in reimbursement rates by October 31, 2027.

Allocates $2 million over two years from both state and federal funds to support these enhanced Medicaid payments.

Who It Names or Affects

Healthcare providers offering maternal health services in rural and frontier areas of Wyoming.

Medicaid clients receiving prenatal, intrapartum (during childbirth), and postpartum care in eligible areas.

Terms To Know

Eligible provider

A healthcare professional who is actively enrolled in Medicaid, has relevant privileges at a labor and delivery facility, and holds specific medical licenses such as obstetrician-gynecologist or family physician providing obstetrical services, midwife, general surgeon providing cesarean section backup, or any other health care provider as determined by rules set by the department.

Rural and frontier areas

Areas designated by the Wyoming Department of Health based on federal guidelines that are sparsely populated and may have limited access to healthcare services.

Limits and Unknowns

The bill did not pass in its current session, so it has no legal effect at this time.

Details about how 'rural and frontier areas' will be defined by the Department of Health are not specified in the text.

Current Bill Text

Read the full stored bill text

26LSO-0353
2026
STATE OF WYOMING
26LSO-0353
Numbered
2.0

HOUSE BILL NO. HB0064

Enhanced Medicaid reimbursement rate-maternal services.

Sponsored by: Representative(s) Clouston, Campbell, E and Connolly and Senator(s) Boner, Brennan, Landen, Nethercott and Schuler

A BILL

for

AN ACT relating to medical assistance and services; authorizing the department of health to apply for enhanced Medicaid reimbursement for eligible providers of maternal services; providing definitions; providing purposes for enhanced reimbursement rates; requiring reports; providing appropriations; requiring rulemaking; and providing for effective dates.

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

Section 1
.

(a)

The department of health shall apply to the centers for Medicare and Medicaid services of the United States department of health and human services for authorization to reimburse eligible providers at an enhanced rate for maternal services provided to eligible Medicaid clients in rural and frontier areas. As used in this section:

(i)

"Eligible provider" means a health care provider who is actively enrolled in Medicaid, has relevant privileges at a labor and delivery facility and is licensed as one (1) or more of the following:

(A)

An obstetrician gynecologist;

(B)

A family physician who provides obstetrical services;

(C)

A midwife;

(D)

A general surgeon who provides cesarean section backup;

(E)

Any other health care provider as determined by rule of the department of health.

(ii)

"Rural and frontier areas" shall be determined by the department of health.

(b)

The purposes of the enhanced reimbursement rate authorized by this section are to:

(i)

Increase access to prenatal, intrapartum and postpartum care;

(ii)

Reduce maternal and neonatal morbidity and mortality;

(iii)

Preserve obstetric provider capacity in rural Wyoming.

(c)

The department of health shall report to the joint appropriations committee and the joint labor, health and social services interim committee on or before October 31, 2027 regarding the additional costs incurred by the increased reimbursements required by this act. The report required by this section shall include any recommendations for modifications to the increased reimbursement for eligible providers under the Wyoming Medical Assistance and Services Act.

Section 2.

There is appropriated one million dollars ($1,000,000.00) from the general fund and one million dollars ($1,000,000.00) from federal funds to the department of health for the purpose of enhancing Medicaid reimbursement for eligible providers as provided by section 1 of this act. These appropriations shall be for the period beginning July 1, 2026 and ending June 30, 2028. These appropriations shall not be transferred or expended for any other purpose and any unexpended, unobligated funds remaining from these appropriations shall revert as provided by law on June 30, 2028. It is the intent of the legislature that these appropriations be included in the standard budget for the department of health for the immediately succeeding fiscal biennium.

Section 3.

The department of health shall promulgate all rules necessary to implement this act.

Section 4
.

(a)

Except as provided by subsection (b) of this section, this act is effective when the state plan amendment authorized by this act is approved by the centers for Medicare and Medicaid services
.

(b)

Section 1(a) and section 4 of this act are 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)

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HB0064