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Government, Politics & Issues

Missouri Senate Committee Pitches New Medicaid Funding Rules For Medical Providers Like Planned Parenthood

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The Missouri Capitol Building

A Missouri Senate committee is proposing changes to Medicaid funding eligibility for medical providers in an apparent attempt to raise qualifying standards for family planning agencies like Planned Parenthood.

The suggested changes come after efforts from some Missouri legislators, who are opposed to abortion rights, to block state Medicaid funding to Planned Parenthood during a special legislative session failed.

Under proposed regulatory changes, the Department of Social Services and the Department of Health would have greater investigative power, including the ability to share information uncovered during investigations to expedite the process of revoking or denying a license to a provider found in violation of either fraud or abuse by the state.

Sen. Bill White, R-Joplin, said Thursday the new rules provided by the Senate Interim Committee on Medicaid Accountability and Taxpayer Protection serve to expedite and expand the investigation process concerning whether a Medicaid-eligible provider is in violation.

“One, they’re able to do joint examinations to reach their conclusions quicker and that they tighten up the criteria for their investigations,” White said.

In addition to the greater investigative power, the committee recommended the agencies expand the definition to what qualifies as a violation to include “ethical and other regulatory and licensing violations.” That could include a failure to retain medical records or not cooperating with an agency in an investigation.

Because the suggestions are regulation based, they do not need legislative approval. Instead, if the proposed changes are approved by the committee, which could happen in the coming days, they then go through the administrative rules process, which includes a public comment period.

One committee member, Sen. Lauren Arthur, D-Kansas City, spoke about her concerns over the ambiguity of the language and whether it puts Missouri at odds with the federal government and therefore could jeopardize federal Medicaid funding.

“Until there is that assurance that we’re in compliance, I think, we’re taking a gamble that I’m not comfortable with,” Arthur said.

Arthur also said if this is indeed a “backdoor attempt” to defund Planned Parenthood, she worries about the impact it could have on health care access.

In response, White said that the Missouri Constitution disallows the targeting of a specific entity and that these proposed rules avoid that.

“This would apply to any abortion provider in the state, any affiliates and not just to them. The criteria that [we’re] using would be to all agencies of a comparable level,” White said.

Planned Parenthood is currently the only abortion provider in the state. Planned Parenthood Advocates in Missouri issued a statement Thursday that said:

“After their failed attacks on patients’ access to birth control and Planned Parenthood this summer, Republican lawmakers are once again trying to block Missourians’ access to health care. The latest proposal is a desperate attempt to 'defund' Planned Parenthood — which means denying patients who rely on Medicaid the right to get their birth control, cancer screenings, and STI testing/treatment at Planned Parenthood health centers.”

M’Evie Mead, director of the organization, said this could also risk Missouri’s entire Medicaid program.

“Barring Medicaid patients from choosing Planned Parenthood for their health care violates the free choice of provider Medicaid law,” Mead said.

In addition to the regulatory changes, the committee proposed statutory changes that would give the social services department the authority to “suspend, revoke or cancel” an existing provider agreement or deny a new contract if the provider or an affiliate has committed “fraud, abuse or unethical behavior” in a different state’s Medicaid program.

Whether an out-of-state violation would result in penalties for an affiliated provider in Missouri, White said that’s ultimately a departmental decision.

“We’re just giving them one more thing they can look at,” White said.

Unlike the regulation proposals, the statutory proposal would require legislative approval. White said it would likely be added as an amendment to an existing bill next session.

Senate President Pro Tem Dave Schatz, R-Sullivan, established the special committee in June to study and draft recommendations regarding the state’s Medicaid spending on family planning establishments like Planned Parenthood.

Follow Sarah Kellogg on Twitter: @sarahkkellogg

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