Nixon Administration Fails to Pay Medicaid Providers Lawful Rates

Governor Nixon’s Division of Budget and Planning has refused to pay Medicaid providers of complex rehabilitation equipment at the rates approved in the fiscal year 2015 budget. Their decision to reinterpret a bill approved by the General Assembly and Governor sets a dangerous precedent of administrative overreach.

Complex rehabilitation technology is equipment that has been modified to suit a person’s unique needs, such as specialized wheelchairs. Providing individualized equipment to Medicaid patients is labor-intensive work, so the legislature increased the payment rates to properly compensate providers for their work.

The Governor vetoed the $500,000 increase for this program as part of the $1.1 billion he restricted from the fiscal year 2015 budget. Yet because he approved the language modifying rates for complex rehabilitation providers, this part of the bill became law.

Even though the new rates were approved by both Chambers of the General Assembly and the Governor, Budget and Planning instructed Missouri’s Medicaid system, Mo HealthNet, not to honor the increased rates. Mo HealthNet was told that the intent of the partial veto was to continue paying the fiscal year 2014 rates for complex rehabilitation technologies.

Once a bill has gone through the legislative process, the bureaucracy should not reinterpret the statute to suit its needs. The role of executive agencies is to carry out laws as they are written, not to pick and choose which sections they want to follow.

At the August 26 joint Budget and Appropriations – Health, Mental Health, and Social Services oversight hearing, the committees heard testimony from the director of Mo HealthNet and two medical equipment providers affected by the decision to ignore the increased rates. After the hearing, I met with the Mo HealthNet director and House budget staff to further discuss this issue.

While I am not sure what the outcome will be, House committees will continue to oversee the Division of Budget and Planning’s role in the budget process. Willfully ignoring a section of statute is a serious breach of public trust, and the administration ought to be held accountable for this decision.