House approves Caldier bill to ensure Medicaid behavioral health providers receive their appropriate reimbursements

No longer may managed care insurance organizations (MCOs) keep Medicaid rate reimbursement increases meant for behavioral health providers under the bill unanimously approved Friday by the state House of Representatives.

Rep. Michelle Caldier, a member of the House Health Care and Wellness Committee, said she introduced House Bill 2584 out of frustration that rate increases meant for mental health and specific behavioral health providers who see Medicaid patients were not receiving the money.

“A few years ago, the Legislature provided rate increases for mental health and specific behavioral services, which were supposed to go to the providers. We gave these increases to the managed care insurance companies for them to pass along to the providers. Instead, they took and kept all those increases,” said Caldier, R-Port Orchard.

Providers who are not properly reimbursed are less likely to see Medicaid patients, which then makes it difficult for these patients to receive the behavioral health services they need.

“It’s been at least 18 months since the Legislature authorized a rate increase for providers, but Kitsap Mental Health Services, which predominantly sees Medicaid patients and cannot deny services, has not seen a dime of that increase. This bill requires managed care insurance organizations to make sure providers receive the rate increases intended for them,” added Caldier. “It also has reporting and accountability requirements so this never happens again.”

Caldier said this legislation is a priority of the Children’s Mental Health Work Group, of which she is a member.

“We’re working to identify and break barriers to behavioral health services and strategies for youth and their families. We want to make sure Medicaid patients are able to access behavioral health services when they need it,” said Caldier.

The measure now heads to the Senate for further consideration.


Washington State House Republican Communications