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Bill

SB 29

Revises provisions relating to Medicaid. (BDR 38-450)

2025 Regular Session

SB 29 would shift Medicaid to value‑based payments by funding ACOs, conduct biennial provider surveys, and seek SPAs to raise reimbursement rates for physicians and APRNs.

(Pursuant to Joint Standing Rule No. 14.3.1, no further action allowed.)
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Bill Summary · SB 29

SB 29 — Revises provisions relating to Medicaid (BDR 38‑450)

Status: Introduced; (per materials provided) “Pursuant to Joint Standing Rule No. 14.3.1, no further action allowed.”
Introduced: August 15, 2025

Main purpose

SB 29 directs the state Medicaid agency to redesign parts of Medicaid reimbursement to (1) enable payment through accountable care organizations (ACOs) that emphasize high‑quality primary care and value, (2) survey Medicaid providers biennially to identify improvements in billing/reimbursement and provider utilization, and (3) seek increases in reimbursement rates for physicians and advanced practice registered nurses (APRNs) via a State Plan Amendment (SPA).

Key provisions

  • Accountable Care Organization reimbursement

    • Requires the Department (Division of Health Care Financing and Policy or equivalent) to develop and implement a Medicaid reimbursement system that pays through ACOs focused on high‑quality primary care, including incentive payments and other value‑based arrangements.
    • Any ACO wishing to participate must demonstrate that it improves health outcomes and lowers costs compared with traditional care delivery models.
    • Implementation conditioned on availability of federal financial participation; the Department must apply for any necessary CMS waivers or SPA amendments and cooperate with federal officials during those application processes.

  • Provider survey (biennial)

    • Mandates a biennial survey of Medicaid participating providers to collect recommendations for improving:
    • How providers request and receive Medicaid reimbursement; and
    • Utilization of Medicaid providers.
    • “Provider of health care” is as defined in existing statutes.

  • Reimbursement rate action

    • Directs the Department to request a SPA to increase Medicaid reimbursement rates for physicians and APRNs (physician and APRN rate increases are explicitly identified as a required SPA request).

  • Administrative alignment

    • Conforming amendment to state administrative statute placing the new ACO/survey responsibilities explicitly within the Department’s program administration.

Who is affected

  • Medicaid beneficiaries — potential changes in care delivery if ACOs are adopted and incentivized.
  • Medicaid providers — physicians, APRNs, clinics and other providers may see higher rates (if SPA approved) and new payment models (ACOs/value‑based payments). Provider participation and billing processes could change after survey recommendations.
  • State Medicaid agency and divisions — new administrative responsibilities (developing ACO frameworks, applying for federal approvals, conducting surveys).
  • State budget and federal partners — changes may produce increased state costs (unless offset by federal match and/or savings achieved through ACO performance).

Potential impacts and considerations

  • Fiscal: Increasing provider rates and implementing incentive payments could raise Medicaid expenditures; however, the bill ties ACO participation to demonstrable cost savings and conditions implementation “to the extent” federal match is available. Net fiscal effect depends on (a) CMS approval of waivers/SPAs, (b) the size of any state match, and (c) whether ACOs produce measurable savings.
  • Access and network participation: Higher rates and value‑based arrangements may improve provider participation in Medicaid, improving access to primary care.
  • Administrative workload: The Division will incur administrative work to design ACO payment models, run biennial surveys, prepare SPA/waiver requests, and manage federal interactions.
  • Implementation timeline: No specific implementation dates are prescribed in the bill text; the Department must apply for federal approvals as needed and conduct the survey on a biennial basis.

Procedural note

  • The bill conditions action on federal financial participation and requires active cooperation with federal authorities to secure waivers or SPAs. The bill also makes a conforming change to place these new duties within the Department’s statutory responsibilities.

If you want, I can:
- Draft a short talking points sheet for stakeholders (providers, consumer advocates, budget staff), or
- Produce a one‑page fiscal/operational checklist the Medicaid agency would need to follow to implement the bill.

Compiled from official sources — confirm details with the bill’s official record.

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