Committee trims and advances Medicaid payment change for ambulatory surgical centers

Representative Echols presented House Bill 198 to allow Medicaid recipients to receive specified procedures in ambulatory surgical centers (ASCs) paid at a Medicare-based rate, with the goal of expanding access and lowering total system costs. Members debated the fiscal note and whether state general fund impacts had been fully accounted for.

Legislative fiscal staff explained the fiscal note is based on time‑of‑service rate differences between hospital outpatient rates and ASC rates; adding dental and other services in an earlier version raised the state general fund estimate to roughly $400,000 per year. To address that concern, committee members adopted an amendment removing dental procedures from the bill, which lowered the estimated state general fund impact. The amendment was adopted and the committee reported HB198 favorable as amended; a roll-call recorded 17 yays and 1 nay on the final report out.

Sponsor and supporters argued shifting appropriate procedures to ASCs can reduce total cost of care and improve patient access, while opponents and some members urged more actuarial analysis demonstrating net savings across all payment buckets and true‑up mechanisms.

Next steps: HB198 was reported favorable as amended and will proceed to the House floor; sponsors indicated willingness to refine language and supply actuarial justification for broader coverage.