Government Relations

UM Legislative Update Newsletter

December 18, 2006

Governor’s office releases plan for transformation of Medicaid

Gov. Matt Blunt’s office released a proposal to reform Missouri’s Medicaid program on Thursday, Dec. 7. The plan was developed by Missouri’s Departments of Social Services, Health and Senior Services, and Mental Health based on recommendations by the Medicaid Reform Commission, which reviewed the program in 2005. The commission was created in 2005 with the passage of SB539, which provided for a June 30, 2008, sunset for the state’s current Medicaid program. In the report released last week, the executive agencies proposed 14 recommendations for the governor’s consideration. The governor will evaluate the proposals and announce his plan for the General Assembly’s consideration when it convenes in January.

Following are the 14 main recommendations:

  1. Transform Missouri’s current Medicaid program to “MO HealthNet.”
  2. Transform the Division of Medical Services to the MO HealthNet Division in order to address the provision of quality health care and health care financing.
  1. Give participants a health care home and health care home coordinator in order to focus on the health and wellness of individuals.
  2. Engage participants in health risk assessments.
  1. Develop a plan of care for each participant through consultation with the health care coordinator and allied health professionals to improve health care status and encourage healthy behavior.
  2. Assist MO HealthNet parents in developing independence agreements to help them achieve improved health outcomes and self reliance.
  1. Provide opportunity for participants to access other Medicaid-eligible services by accruing credits earned through healthy behaviors.
  2. Increase physician-related reimbursement in recognition of their assumption of the health care home provider role.
  1. Implement pay-for-performance measures for providers.
  2. Expand strategies to reduce waste, fraud, and abuse and emphasize fiscal accountability.
  1. Increase health insurance availability through small employer premium offsets.
  2. Increase health insurance availability by extending MO HealthNet coverage to workers with disabilities.
  1. Increase health insurance availability by extending MO HealthNet coverage to youth who have aged out of the foster care system.
  2. Increase health insurance availability by redefining affordability for MC+ for Kids (State Children’s Health Insurance Program, or SCHIP).