More details on Governor Steve Bullock’s plan to restore parts of the state budget are expected this week.
On Tuesday, the state health department says it will issue a new rule that will restore a nearly 3 percent cut to how much it pays doctors, clinics and other health care providers who see Medicaid patients, retroactive to July 1 of this year. That’s two months ahead of when the department initially said providers could expect that rate restoration.
However, the specifics remain murky for most of the roughly $45 million in budget cut backfilling Bullock has said the state can now afford.
“We’re just in limbo, again, to just wait and see,” says Mary Windecker, executive director of the Behavioral Health Alliance of Montana, a group of more than 30 providers of behavioral health services to children and adults.
Montana’s health department stands to see the largest dollar restoration of any state agency as a result of revenues coming in higher than projected when the budget cuts were announced last fall.
Since the cuts were made, Medicaid providers that serve the state’s poor, elderly, and disabled have cried out about the devastating blow the funding reduction has caused to their clients and programs. Across the state, services have been eliminated, offices closed and frontline staff let go.
Earlier this month, Windecker, and several hundred other people, showed up in person and online to a meeting with officials to advise the state on how it should prioritize restoring money to programs that pay Medicaid providers.
Windecker says the administration's plans for the restoring parts of the budget are unclear.
“We haven’t gotten a response from our queries to the state in the last few weeks since the listening session. So we don’t know. Has a decision been made on how the money will be re-allocated? Have they decided if they are going to continue with some of the programs being severely cut, like case management? Are they going to reinstate home support services? We just don’t know. So until we are able to sit down and have a conversation with them, or until they post a new rule, we are just kind of in the dark.”
Tensions between providers and the state administration have boiled up at times since the 2017 legislative session.
The state has been sued twice this year by disability rights advocates and a health care association over the handling of cuts to Medicaid providers rates.
The frustration is shared by some lawmakers. Senator Diane Sands is a Democrat from Missoula who sits on a committee with some oversight of the state health department.
Sands says while the department has held some public listening sessions, she is concerned about how collaboratively the state is working with providers.
“Everyone is out there waiting to hear what the decision has been made in Helena. And in my view, that does not comply, really, with our requirements around fundamental commitments to transparency in government, and I think that's unfortunate”
In late July, when Governor Bullock announced state finances were back on track to restore around $45 million to agencies, including over $30 million to the health department, he indicated plans for those funds would be made public before September 1.