S.F. 2083 Section 1. MEDICAID MANAGED CARE —— REIMBURSEMENT OF 1 IN-NETWORK AND OUT-OF-NETWORK PROVIDERS. The department of 2 human services shall adopt rules pursuant to chapter 17A and 3 shall amend all Medicaid managed care contracts to require that 4 beginning July 1, 2018, for each covered service, Medicaid 5 providers that have contracted with a Medicaid managed care 6 organization as an in-network provider be reimbursed at one 7 hundred percent of the fee-for-service reimbursement rate 8 established by the general assembly through the appropriations 9 process for the respective fiscal year, and that Medicaid 10 providers that have not contracted with a Medicaid managed care 11 organization and are considered an out-of-network provider 12 be reimbursed at ninety-five percent of the fee-for-service 13 reimbursement rate established by the general assembly through 14 the appropriations process for the respective fiscal year. 15 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate 16 importance, takes effect upon enactment. 17 EXPLANATION 18 The inclusion of this explanation does not constitute agreement with 19 the explanation’s substance by the members of the general assembly. 20 This bill directs the department of human services (DHS) 21 to adopt rules pursuant to Code chapter 17A and amend all 22 Medicaid managed care contracts to require that beginning July 23 1, 2018, for each covered service, Medicaid providers that 24 have contracted with a Medicaid managed care organization 25 as an in-network provider be reimbursed at 100 percent of 26 the fee-for-service reimbursement rate established by the 27 general assembly through the appropriations process for the 28 respective fiscal year, and that Medicaid providers that have 29 not contracted with a Medicaid managed care organization and 30 are considered an out-of-network provider be reimbursed at 95 31 percent of the fee-for-service reimbursement rate established 32 by the general assembly through the appropriations process for 33 the respective fiscal year. 34 The bill takes effect upon enactment. 35 -1- LSB 5966XS (1) 87 pf/rh 1/ 1