Nevada Medicaid officials confront decline in federal funds

State health officials gave legislators an overview of Nevada’s Medicaid program in an Assembly committee meeting Friday, during which the program’s new administrator said the state program will be tackling a decrease in federal funding in coming years.

“These rates are tied to the overall economy, so when the economy does better, we get a lower … rate from the federal government,” Suzanne Bierman, administrator for the health care financing and policy division of the state Department of Health and Human Services, said in her presentation.

The rate, called a federal medical assistance percentage, determines the share of Medicaid costs covered by the federal government. For the 2019 fiscal year, federal funds cover 65.09 percent of Medicaid costs for the traditional population, including parents, their children and the disabled.

That number is expected to decrease to 64.17 percent in the next fiscal year, though projections to fiscal year 2023 show a slight increase, to 65.99 percent. Bierman cautioned that even seemingly small percentage point changes equate to large dollar amounts.

Bierman said that access to care remains an issue in rural areas of Nevada and that services statewide in behavioral health are limited. Assembly Health and Human Services Committee Chairman Michael Sprinkle, D-Sparks, has said he will propose legislation that would expand access to Medicaid in rural areas.

The state health department has attempted to broaden access through programs like telemedicine and community paramedicine, and it has expanded Medicaid reimbursement to podiatrists and registered dietitians.

“Nevada always ranks really well in terms of the regulations related to the use of telehealth,” Bierman said.

Medicaid also recently updated its computer system for processing claims, which Bierman said would ease administrative burdens.

The state program will propose rate increases for neonatal and pediatric intensive care services, which Bierman didn’t address Friday but wrote into a presentation shared with legislators. Sunrise Hospital and Medical Center in Las Vegas launched a campaign in late 2018 to drum up support from residents for those higher reimbursements.

Bierman told legislators Friday that she sees opportunities for broadening Medicaid’s scope through federal waivers, including one through the federal Centers for Medicare and Medicaid services called a 1915(i) state plan option, which would allow Medicaid to pay for housing-related services to help the homeless.

Medicaid covers about 680,000 Nevadans, providing care for one-fifth of the state’s population and acting as the largest payer in the state, Bierman said Friday.

Contact Jessie Bekker at jbekker@reviewjournal.com or 702-380-4563. Follow @jessiebekks on Twitter.