Health care provider rates remain in limbo 

This story is excerpted from the MT Lowdown, a weekly newsletter digest containing original reporting and analysis published every Friday.

Ever since lawmakers packed up shop and left Helena earlier this month, health care and social service providers have been waiting for their hard-fought, marquee policy issue to bear fruit: a historic boost in state reimbursements for Medicaid services including assisted-living care for seniors, at-home support for people with disabilities and treatments for mental health and addiction. 

In total, Republicans and Democrats approved roughly $330 million in new state and federal funds to support Medicaid rate increases, according to Rep. Bob Keenan, R-Bigfork, the chair of the health budget subcommittee. Providers celebrated the fact that, over the biennium, the adjusted rates will reach 100% of the benchmarks identified by a state-contracted 2022 study.  

It’s often said that “nothing’s dead until sine die,” the official motion to end the legislative session. But when it comes to the budget, nothing about provider rates will be official until House Bill 2 is signed by Gov. Greg Gianforte and the new rates have an effective date on the calendar. 

Weeks have gone by without that long-awaited signature. Anxiety among providers, once described to Montana Free Press as “cautious optimism,” has only increased. Then, on Thursday, MTFP reported that Senate Majority Leader Steve Fitzpatrick, R-Great Falls, asked the governor in a May 18 letter to consider a $15 million line-item adjustment to Medicaid rates — for the sake of frugality. Gianforte exercised that same power this week to trim spending items out of House Bill 5, the state infrastructure bill. 

News of Fitzpatrick’s request did not sit well with some Medicaid providers waiting to make decisions about their upcoming budgets based on how the rate changes shake out. Any cuts to the agreed-upon rates, they said, threaten community services in the long term.

“Vetoing provider rate increases would cost the state more by people receiving services in more-restrictive higher-cost levels of care,” said Matt Bugni, CEO of Anaconda-based provider AWARE. “I appreciate the work of our Legislature regarding funding for home- and community-based Medicaid services. I trust that the governor and our [state health department] understand the behavioral health pressures on our communities and will do what is right for Montana.”