Governor Mark Gordon Vetoes Medicaid Billing For School-based Services Bill

Governor Mark Gordon Vetoes Medicaid Billing For School-based Services Bill

Governor Mark Gordon, from left, Representative John Freeman and Representative Clark Stith weigh in on House Bill 119, the Medicaid billing for school-based services bill.

ROCK SPRINGS — While House Bill 119/HEA No. 46, known as the Medicaid billing for school-based services bill, was approved by the Wyoming Legislature, Governor Mark Gordon vetoed the bill.

“It appears from this bill, more time is needed to fully understand the impact and/or benefit to the state and schools districts,” Governor Mark Gordon stated in his veto letter. “Without the full confidence of the Legislature in this approach, I cannot support using the state’s limited resources to stand up experimental news programs within agencies at this time.”

Had the bill not been vetoed, it would have authorized school districts to bill school-based services for Medicaid-eligible students, which would include providing reimbursement to school districts for administrative costs; providing appropriations; authorizing positions; authorizing a transfer of funds; requiring reports; and providing for effective dates.

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“I am very disappointed by the Governor’s veto of HB119. Forty nine other states have enacted some version of HB119, which provides for school districts to get reimbursed by the federal government for certain services to students, such as speech pathology, that are eligible for Medicaid reimbursement,” Rep. Clark Stith, R-Rock Springs, said.

Rep. John Freeman, D-Green River, disagreed saying “I’m glad he vetoed the bill. It would not save the state very much money and the state didn’t have to set up a new system with very little cost savings. Finally, medicaid recipients kept their full benefits.

According to Stith, who voted in favor of the bill, the Alvarez and Marsal government efficiency study estimated that the state might receive as much as $18 million per year in reimbursements from the federal government. This is money the schools could have used for textbooks, school lunches or to shore upon the shortfall in the special-education budget.   

Stith said the State’s own assessment came in at a lower number than the $18 million, based in part on the perceived administrative burden, but it was still a positive number.

“I believe that the administrative burden from implementing HB119 has been exaggerated,” Stith said.

The History of the Bill

Freeman said the Joint Educational Committee studied the concept of this bill in the interim and determined school districts, especially small ones, didn’t have the capacity to administer the program.

According to Freeman, the Wyoming Department of Education would need to repurpose or the Legislature would need to provide them with more employees to administer the program.

“There was a cash flow problem for districts as well,” Freeman said. “In short, it was going to be a jobs bill. When I learned that Medicaid recipients receive only a finite benefit, I didn’t think the state should rob the poor to meet its needs.The JEC did not bing a bill.”

The Joint Appropriations Committee disagreed with the JEC’s decision and drafted another bill. The JEC added conditions that would allow small districts not to participate. They also allowed large district to opt into a pilot program.

Freeman said in the end, only Laramie County School District No 1 had any interest in piloting the program.

“And they were not enthusiastic,” Freeman said.

Disagreements on the Bill  

“Some school administrators were against HB119, in part because it would require speech pathologists, for example, to keep time sheets, like they do in 49 other states. I don’t like keeping time sheets in my job either, but I do,” Stith said.

Wyoming is the only state without the program, Freeman said.

“Nobody asked the other states if they would like to get out of the program,” Freeman said. “Whispers among (school) superintendents said there were several states that would like to drop the program. Once you get into the program it is hard to get out of – I’m told.”

According to Stith, another objection raised was there is a difference between educational purposes and medical purposes for services such as speech pathology.

“I am sure that is true. That, however, is not an excuse to leave millions of dollars on the table,” Stith said. “For example, if a doctor prescribed speech pathology for a student twice per week, that would not prevent the school from offering it five times per week.”

Freeman disagreed saying, “This bill wouldn’t do much for schools or more important students. Special education teachers would have had more put on their plate without more resources. Special education teachers are difficult to recruit now and when I taught there was a high turnover of those teachers.”

Freeman said the concept would have saved the state between $2 to $3 million, however the bill would not have been implemented fully.”

Both Freeman and Stith agreed the state must do everything it can to save money.

“In Wyoming’s fiscal situation, almost any kind of savings is welcomed,” Freeman said. “However, there was no stomach by the Legislature to give more money to save a little.”    

“Taxpayers don’t mind funding K-12 education when the money is well spent, but when there is an obvious failure to make the school’s dollar stretch as far as it could go, public support for generous K-12 funding may erode,” Stith said.   

To look at the bill in its entirety click here.

To see the Governor Gordon’s complete letter regarding the veto, read the document below.