For reimbursement services support, email us at info@girsinc.com or call us at 901-834-9119.
On July 14, 2020, we wrote a Blog on Medicaid Fee-for-Service Expansion. In the blog, we mentioned that even before the pandemic, Missouri, Oklahoma, as well as North Carolina and Kansas were considering the benefits of Medicaid expansion.
In the August 2020 election, voters in Missouri approved generating a state constitutional amendment that will allow healthy adults to qualify for Medicaid beginning July 1, 2021. Missouri, along with five other conservative states have approved Medicaid expansion via ballot initiatives. The state plan amendment must be submitted to the federal government by March 2021. Oklahoma is the latest state which voted in the measure on June 30. The other 12 states that haven’t expanded Medicaid are Republican states in the South.
Medicaid expansion has been aggressively fought by Republican lawmakers and was placed on the ballot as the result of a petition. The expansion was approved by more than 50 percent of the voters. Medicaid expansion allows individuals and families with incomes up to 138% of the federal poverty level to be eligible for benefits. However, the amendment that voters passed in Missouri forbids the state from imposing added eligibility requirements (other than the Accountable Care Act’s income and immigration requirements) on the expansion population that aren’t also required of the rest of the state’s Medicaid-eligible population.
Meanwhile, while local officials are against the expansion, health care advocates reason that the expansion will benefit individuals and families who are struggling as an effect of the pandemic and that the arrival of federal dollars and the jobs that result from expansion could help the economy. Health care authorities also agree that the economic effects of the pandemic, such as high unemployment and declined state revenue, could strain the size of state Medicaid programs. Ninety percent of the expansion’s cost are covered by the federal government.
Missouri will be the sixth state to expand Medicaid this way, after state representatives and the governor had formerly banned the idea of Medicaid expansion.
Why Partner with GIRS
As more patients become Medicaid recipients and as Medicaid expansion grows, GIRS is #LookingAheadoftheCurve by educating clients about the potential impact on their payer mix and redefining payer market access strategies to secure Medicaid coverage and preferred status for their products.
We are currently working with all Medicaid Fee-for-Service programs educating them about the clinical and cost data for our client’s Products and assisting with the appropriate pricing of these Products. We also are working with Medicaid managed care plans to advocate for coverage and appropriate payment.
For more information, email us at info@girsinc.com or call us at 901-834-9119.
Disclaimer: The information in this blog is based on payer information which is dynamic. It is accurate at the time of posting but should not be construed to be reimbursement or legal advice. CPT® is the trademark of the American Medical Association (AMA).
Sources:
https://www.healthinsurance.org/missouri-medicaid/
About GIRS
For more than 17 years, GIRS has been assisting medical technology manufacturers with their market uptake and reimbursement strategies so that patients can have access to the care that they need. To implement successful market access strategies, the GIRS Value Discovery Landscape Assessments® team and the Payer Advocacy Compass® team work together to develop and implement foundation reimbursement landscape and payer advocacy strategies to obtain positive coverage, appropriate payment, and innovative payer contracting arrangements to improve market uptake. For more information, email us at info@girsinc.com or call us at 901-834-9119.