Committee removes physician-visit caps from Medicaid policy

The Senate Committee on Administrative Rules voted to adopt SJR 52, which removes numerical caps on physician visits previously written into Medicaid policy.

Melissa Miller, State Medicaid Director, told the committee the limits (four visits per month, two in nursing facilities) are antiquated and can deter access to primary care, especially in rural areas. "We feel like this is counter to our efforts to do rural health and expand access," Miller said, adding the change should reduce avoidable emergency-room visits over time and improve continuity of care.

After limited debate and a due-pass motion, the clerk recorded 8 ayes and 1 nay and the resolution was declared passed. The agency noted the change aligns with priorities for rural health transformation and said the expected long-term effect is lower high-cost utilization because members will seek primary care first.