Nevada legislators heard introductions for three bills in the Assembly and Senate health committees Monday, including one that would appropriate $15 million to general public health needs.
The others target Medicaid. One would study the financial impact of increasing reimbursements — which experts have long expressed are lower than most states. The other would mandate that the state program for low-income Nevadans covers the cost of donor breast milk.
Assemblyman Michael Sprinkle, D-Sparks, who chairs the Assembly health and human services committee, sponsored AB97, the public health funding bill, and AB116, which mandates the study of Medicaid reimbursements.
He was joined in presenting the bill by Washoe County District Health Officer Kevin Dick, who said that upping funds designated to public health could improve access to health care and reduce the economic burden of disease.
“Ultimately, the flexibility in this funding allows health authorities to address root causes in social determinants of health,” Dick said.
Nevada, which ranks 50th in the U.S. for public health spending, allocates $6.75 per capita on public health. The fund would bring that number to $9.25, increasing Nevada’s rank to 49th.
The national median on per capita public health spending is $38.13, according to Dick.
Public health funds could play a role in preparing the state should a public health emergency occur, like
such as the measles outbreak in Washington, which had infected 61 people as of Monday.
Medicaid reimbursements
Sprinkle also introduced AB116, which would call for studying the cost of increasing Medicaid reimbursements to 90 percent of what Medicare pays. Physicians in Nevada have long complained that low Medicaid reimbursement rates kept physicians from accepting patients under the program, therefore impeding access to care.
Rates vary by service provided and provider type.
“Today, it’s just a questions of really knowing where we stand and what it would take so our reimbursement rates across the board are not picking winners and losers every two years,” Sprinkle told legislators Monday.
A preliminary analysis from the Department of Health and Human Services Division of Health Care Financing and Policy found that increasing Medicaid rates to meet Medicare rates would cost the state $174.1 million over the biennium, but cautioned the estimate was likely conservative and the cost could be greater.
A Nevada Medicaid representative said the agency would hire an outside consulting firm to complete the analysis, which would take $148,000 and 14 weeks.
Representatives from Nevada hospitals and health care professional associations expressed support for both bills, anticipating the legislation would positively impact patient care.
Donor breast milk
Republican Sen. Scott Hammond introduced what he called “one of the best things I’ve worked on” Monday evening in the form of a bill that would require Nevada Medicaid to cover the cost of donor breast milk for the smallest neonatal intensive care unit infants.
SB 115 comes with a $25.1 million fiscal note from the Division of Health Care Financing and Policy, which administers the state Medicaid program.
Hammond attempted to quiet concerns from committee chair Sen. Julia Ratti, D-Sparks, who expressed confusion regarding the need for donor breast milk coverage within the program by comparing the cost of donor breast milk to those associated with long-term complications and NICU stays.
“What I’m really wanting to dig into is are we really moving the needle, or are we just replacing the funding?” Ratti said.
Nevada Medicaid administrator Suzanne Bierman said cost estimates likely were overstated.
Industry representatives, including Elena Medo, CEO of Medolac Laboratories, a Boulder City-based producer of donor breast milk, testified in support of the bill.