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Social Services Appropriations Subcommittee - February 04, 2020
30 House Building
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Recording 1
1. Call to Order
Chair Ray called the meeting to order at 8:30 a.m.
2. Approval of Minutes None
3. Unfinished Items from the Previous Agenda
Medicaid Consensus and Local Authority Behavioral Health Funding.
Federal Government's Proposed Medicaid Financing Reforms
Clare Tobin Lence, Finance Manager, Office of the Legislative Fiscal Analyst (LFA), presented an introduction of the brief.
11a-Administration Proposes Medicaid Financing Reforms - FFIS Issue Brief 19-36
Lincoln Shurtz, Director of Government Affairs, Utah Association of Counties, reviewed the process of obtaining Medicaid funding for counties.
Brandon Hatch, Director, Davis Behavioral Health, explained a request for funding their services.
Chair Ray inquired why all fluctuation costs be born by the State. Brandon Hatch replied with continued comment from Rep. Ray and input from Lincoln Shurtz.
Rep. Ward asked staff if this request will be part of the Consensus estimate process and what that process is. Russell Frandsen, Finance Officer, LFA, clarified with continued questions from Rep. Ward and input from Lincoln Shurtz.
Rep. Judkins asked why mental health issues are not considered the same as physical health issues. Lincoln Shurtz explained.
Russell Frandsen continued to clarify. Rep. Judkins made further comment with comment from Chair Ray.
Sen. Escamilla commented further on mental health issues and made a suggestion.
Lincoln Shurtz made closing comments on funding.
Chair Ray gave closing input to the subject.
Clare Tobin Lence referred to a motion from 2/3/2020 for dedicated credits to the Utah State Hospital, requested by the Department of Human Services.
DSAMH
Sen. Christensen moved to approve: in addition to the authority granted in motion #CH3 from the sheet entitled "Social Services Appropriations Subcommittee - Motions for Consideration" dated 1/27/2020, authorize an increase in dedicated credit authority of $1.3 million one-time in FY 2020 and $1.3 million ongoing in FY 2021 for the purpose of increased private insurance collections at the Utah State Hospital.
Rep. Judkins requested clarification on the motion. Clare Tobin Lence explained the information.
4. Public Input on Topics on Today's Agenda None
Rep. Christiansen asked for further clarification on the funding. Clare Tobin Lence clarified.
A Performance Audit of PEHP's Pharmacy Benefit Manager (as it relates to Medicaid)
5a-2019-13 Audit of PEHP's PBM - 2-4-2020
5a-PBM Basics - Utah Feb 2020 - LS EDIT
Benn Buys, Audit Manager, Office of the Legislative Auditor General (OLAG), introduced the audit and explained its purpose.
Sarah Flanigan, Performance Auditor, OLAG, explained the audit.
Rep. Coleman referred to a slide and asked for clarification about data. Benn Buys gave an explanation. There was continued conversation including comment from Chair Ray.
Sarah Flanigan further addressed the question.
Rep. Thurston commented. Sarah Flanigan and Benn Buys clarified. Rep. Thurston asked another question which was answered by Benn Buys.
Lincoln Shurtz represented CVS Pharmacy to explain how the Accountable Care Organizations is involved in the Pharmacy Benefit Manager (PBM).
A Performance Audit of PEHP's Pharmacy Benefit Manager (as it relates to Medicaid)
5b-A Performance Audit of PEHP's Pharmacy Benefit Manager
Chair Ray voiced concern about the PBM program and Lincoln Shurtz responded.
Rep. Judkins voiced concern about prices not decreasing. Lincoln Shurtz explained the reason for increases. There was continued conversation to clarify rebates vs. coupons.
Chair Ray continued explanation about rebates.
Rep. Daw commented about a new program being developed to decrease drug prices.
Rep. Coleman also had a question about the amount of money being given plan sponsors and Lincoln Shurtz responded.
Rep. Christiansen asked if there is a possibility to purchase drugs from outside the typical supply chain. Lincoln Shurtz responded. Rep. Christiansen further commented.
Rep. Thurston commented on manufacturers of drugs produced by three major purchasers and manufacturers. Lincoln Shurtz responded with further comment from Rep. Thurston.
Medically Complex Children's Waiver
Rep. Dailey-Provost introduced Autumn McKnight.
Autumn McKnight, resident, testified in support of the services provided to her son through the Children's Waiver.
Rep. Ward requested information about how many are on the list for the waiver. Tonya Hales, Assistant Director, Medicaid replied.
Chair Ray asked for the average time of service. Tonya Hales stated she would find the information and inform the Subcommittee.
Accountable Care Organization Rates
Maddy Oritt, Economist, Office of the Legislative Fiscal Analyst, explained the information.
8-Medicaid ACO (Jan 2020 Update)
Availability to Test Medicaid Individuals Under Certain Circumstances
Mike Murano, President, Beechtree Diagnostics, explained the processes used to test individuals.
Rep. Ward requested more detailed information and to have another meeting with Mike Murano individually.
Federal Government's Proposed Medicaid Financing Reforms
Nate Checketts, Deputy Director, Utah Department of Health (UDOH), explained the dynamics of the financing reforms.
11a-Administration Proposes Medicaid Financing Reforms - FFIS Issue Brief 19-36
11b-01-29-2020 Letter to Administrator Verma - Medicaid Fiscal Accountability
Rep. Dailey-Provost asked for clarification on the proposed rule and the logic behind it. Nate Checketts explained the reasoning behind the decision.
Rep. Ward asked if the rule was finalized. Nate Checketts responded in the negative. There was continued discussion.
Rep. Judkins asked if this was a bad thing and Nate Checketts responded.
Russell Frandsen spoke to the question.
Budget Reduction Options
13a-SS Report - 90 Day Supply of Prescription Drugs
Russell Frandsen reviewed items on the Budget Reduction sheet including items #14, 21, and 22.
Dave Gessel, Vice President, Government Relations and Legal Affairs. Utah Hospital Association spoke in regard to rural hospitals remaining open.
Nate Checketts commented on building costs as well as being able to keep savings.
Russell Frandsen referred to the Motions for Subcommitttee Consideration (blue sheet) Medicaid Services and Associated Funds, #BJ 1-4 Motions, and reviewed those motions.
Nate Checketts spoke to the remaining #BJ 5-10 and 12-13, and15 motions
Rep. Judkins asked if BJ 4 and 2 are related. Russell Frandsen responded. There was another question on BJ 11. Nate Checketts responded that they would be glad to discuss that.
Russell Frandsen discussed this.
Follow up on An In-Depth Budget Review of the Utah Department of Health
6-Issue Brief - 2020 General Session - An In-Dept Budget Review of the Utah Department of Health
Update on Opioids Prescribed
10-SS - Report - Medicaid - Opioid - Reductions
Russell Frandsen, explained the brief information.
Report on Recommendations for Medicaid Compensation for Caregivers
12-SS Report - Caregiver Compensation
Russell Frandsen explained the dynamics.
Sen. Christensen moved to approve all the BJ motions excluding BJ14, BJ16 and BJ17 from the sheet entitled "Social Services Subcommittee - Motions for Subcommittee Consideration" dated 1/27/2020..
Chair Ray reminded everyone about the meetings tomorrow.
Rep. Daw moved to adjourn.
Chair Ray adjourned the meeting at 10:52 AM.
Call to Order
Call to Order
Approval of Minutes
Approval of Minutes
Unfinished Items from the Previous Agenda
Unfinished Items from the Previous Agenda
Public Input on Topics on Today's Agenda
Public Input on Topics on Today's Agenda
A Performance Audit of PEHP's Pharmacy Benefit Manager (as it relates to Medicaid)
A Performance Audit of PEHP's Pharmacy Benefit Manager (as it relates to Medicaid)
Follow up on An In-Depth Budget Review of the Utah Department of Health
Follow up on An In-Depth Budget Review of the Utah Department of Health
Availability to Test Medicaid Individuals Under Certain Circumstances
Availability to Test Medicaid Individuals Under Certain Circumstances
Accountable Care Organization Rates
Accountable Care Organization Rates
Medically Complex Children's Waiver
Medically Complex Children's Waiver
Update on Opioids Prescribed
Update on Opioids Prescribed
Federal Government's Proposed Medicaid Financing Reforms
Federal Government's Proposed Medicaid Financing Reforms
Report on Recommendations for Medicaid Compensation for Caregivers
Report on Recommendations for Medicaid Compensation for Caregivers
Review of Department of Health's Medicaid Services Budget
Review of Department of Health's Medicaid Services Budget
Other Business
Other Business
Written Reports
Written Reports
AGENDA
AGENDA
MINUTES
MINUTES
NOTICE
NOTICE
3-Motion - DHS - Utah State Hospital Dedicated Credits
3-Motion - DHS - Utah State Hospital Dedicated Credits
5a-2019-13 Audit of PEHP's PBM - 2-4-2020
5a-2019-13 Audit of PEHP's PBM - 2-4-2020
5a-PBM Basics - Utah Feb 2020 - LS EDIT
5a-PBM Basics - Utah Feb 2020 - LS EDIT
5b-A Performance Audit of PEHP's Pharmacy Benefit Manager
5b-A Performance Audit of PEHP's Pharmacy Benefit Manager
6-Issue Brief - 2020 General Session - An In-Dept Budget Review of the Utah Department of Health
6-Issue Brief - 2020 General Session - An In-Dept Budget Review of the Utah Department of Health
7a-Legislative Presentation 02042020
7a-Legislative Presentation 02042020
8-Medicaid ACO (Jan 2020 Update)
8-Medicaid ACO (Jan 2020 Update)
10-SS - Report - Medicaid - Opioid - Reductions
10-SS - Report - Medicaid - Opioid - Reductions
11a-Administration Proposes Medicaid Financing Reforms - FFIS Issue Brief 19-36
11a-Administration Proposes Medicaid Financing Reforms - FFIS Issue Brief 19-36
11b-01-29-2020 Letter to Administrator Verma - Medicaid Fiscal Accountability
11b-01-29-2020 Letter to Administrator Verma - Medicaid Fiscal Accountability
12-SS Report - Caregiver Compensation
12-SS Report - Caregiver Compensation
13a-SS Report - 90 Day Supply of Prescription Drugs
13a-SS Report - 90 Day Supply of Prescription Drugs
13d-PDL Psych Year End Report 2019-11
13d-PDL Psych Year End Report 2019-11
15a-2019-11-30 HB 400 Report
15a-2019-11-30 HB 400 Report
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