H.F. 205 DIVISION I 1 INTEGRATED PROVIDER NETWORK PROVIDERS —— REIMBURSEMENT RATE 2 Section 1. INTEGRATED PROVIDER NETWORK PROVIDERS —— 3 MEDICAID PROVIDERS —— REIMBURSEMENT. The department of 4 human services shall establish an integrated provider network 5 provider as a participating provider type under the Medicaid 6 program consistent with the community mental health system 7 provider type. The department shall reimburse the integrated 8 network provider type consistent with the Medicaid community 9 mental health center enhanced fee schedule. 10 DIVISION II 11 SUBSTANCE USE DISORDER TREATMENT SERVICES AND BEHAVIORAL HEALTH 12 SERVICES PROVIDERS —— REIMBURSEMENT RATE 13 Sec. 2. SUBSTANCE USE DISORDER TREATMENT SERVICES AND 14 BEHAVIORAL HEALTH SERVICES PROVIDERS —— REIMBURSEMENT RATES. 15 1. The department of public health in collaboration 16 with the department of human services shall review and make 17 recommendations for Medicaid 1915(b)(3) waiver reimbursement 18 rates for substance use disorder intensive outpatient and 19 residential treatment services using a projected cost report 20 agreed upon by the departments and the integrated provider 21 network providers. The departments shall establish time frames 22 for release of the agreed-upon projected cost report form to 23 providers and the deadline for submission of the completed 24 projected cost reports by providers to the departments, in 25 order to allow sufficient time for review and the making of 26 recommended adjustments to the Medicaid 1915(b)(3) waiver 27 reimbursement rates for Medicaid integrated provider network 28 providers. 29 2. The department of public health in collaboration with 30 the department of human services and behavioral health services 31 providers shall review reimbursement rates for behavioral 32 health services and Medicaid 1915(b)(3) waiver services using 33 the projected cost report agreed upon by the departments and 34 the integrated provider network providers. The departments 35 -1- LSB 1741YH (6) 89 pf/rh 1/ 3

H.F. 205 shall establish time frames for release of the agreed-upon 1 projected cost report form to behavioral health services 2 providers and the deadline for submission of the completed 3 projected cost reports by behavioral health services providers 4 to the departments, in order to allow sufficient time for the 5 departments to review and make recommended adjustments to 6 the Medicaid 1915(b)(3) waiver reimbursement rates and the 7 behavioral health services fee schedule. 8 3. The department of public health, in collaboration with 9 the department of human services, shall establish an ongoing 10 plan for regular review of reimbursement rates for providers 11 of substance use disorder treatment services and behavioral 12 health services and provide information to the governor and the 13 general assembly in a timely manner to allow for the provision 14 of appropriate funding for any change in reimbursement rates. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill relates to reimbursement rates for providers of 19 substance use disorder treatment services and behavioral health 20 services. 21 Division I of the bill requires the department of human 22 services (DHS) to establish an integrated provider network 23 provider as a participating provider type under the Medicaid 24 program consistent with the community mental health system 25 provider type. The bill requires DHS to reimburse the 26 integrated network provider type consistent with the Medicaid 27 community mental health center enhanced fee schedule. 28 Division II of the bill relates to reimbursement rates 29 for providers of substance use disorder treatment services 30 and behavioral health services. Division II requires the 31 department of public health (DPH), in collaboration with DHS, 32 to review and make recommendations for Medicaid 1915(b)(3) 33 waiver reimbursement rates for substance use disorder intensive 34 outpatient and residential treatment services using a projected 35 -2- LSB 1741YH (6) 89 pf/rh 2/ 3

H.F. 205 cost report agreed upon by the departments and the integrated 1 provider network providers. The departments are required 2 to establish time frames for release of the agreed-upon 3 projected cost report form to providers and the deadline for 4 submission of the completed projected cost reports by providers 5 to the departments, to allow sufficient time for review and 6 adjustments to reimbursement rates for Medicaid integrated 7 provider network service providers. Division II also requires 8 DPH, in collaboration with DHS and behavioral health services 9 providers, to review reimbursement rates for behavioral health 10 services and Medicaid 1915(b)(3) waiver services using the 11 projected cost report agreed upon. Again, the departments 12 shall establish time frames and deadlines for the cost reports 13 to allow sufficient time for the departments to review and make 14 recommended adjustments to the reimbursement rates and the 15 behavioral health services fee schedule. Finally, the division 16 directs DPH in collaboration with DHS to establish an ongoing 17 plan for regular review of reimbursement rates for providers of 18 substance use disorder treatment services and behavioral health 19 services and to provide information to the governor and the 20 general assembly in a timely manner to allow for the provision 21 of appropriate funding for any change in reimbursement rates. 22 -3- LSB 1741YH (6) 89 pf/rh 3/ 3