senate Bill S6065

2011-2012 Legislative Session

Expands the duties of the special advisory review panel on Medicaid managed care to include other managed care programs

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

do you support this bill?

Actions

view actions (1)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 04, 2012 referred to health

Co-Sponsors

S6065 - Bill Details

See Assembly Version of this Bill:
A7651A
Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd ยง364-jj, Soc Serv L

S6065 - Bill Texts

view summary

Relates to the membership and expands the duties of the special advisory review panel on Medicaid managed care by including other managed care programs.

view sponsor memo
BILL NUMBER:S6065

TITLE OF BILL:
An act
to amend the social services law, in relation to the special advisory
review panel on Medicaid managed care

PURPOSE:
To update the composition and the charge of the Medicaid Managed Care
Advisory Review Panel (MMCARP).

SUMMARY OF PROVISIONS:
The bill amends section 364-jj of the Social Services Law to add Child
Health Plus, Family Health Plus, Managed Long Term Care and other
public managed-health care plans to the charge of the MMCARP and add
two public members with expertise in disabilities and pediatrics. The
bill would also have MMCARP review issues of the appropriateness and
timeliness of services, the integration of federal health care
reform, trends in service denials and demographic data as well as
review of federal waiver.

JUSTIFICATION:
Since the statute's enactment in 1996, the MMCARP has performed an
important function collaboratively working with numerous state
officials in monitoring mandatory Medicaid managed care.

Provisions in the 2011-2012 budget will result in the expansion of
mandatory Medicaid managed care to vulnerable populations who were
previously covered by fee-for-service, including physically and
developmentally disabled individuals, children in foster care, and
homeless families. There will also be a significant increase in home
care beneficiaries enrolled by mandate into managed long term care
plans, forcing individuals with complex needs to manage their care in
a new delivery system. It is increasingly important that the MMCARP
provide an opportunity
for monitoring of these programs by a diverse group of stakeholders
including consumer advocates, consumers, health plans and providers
of services.

This bill will charge MMCARP with monitoring the phase-in schedule for
the enrollment of new populations in Medicaid managed care as well as
the availability of essential services for these populations. In
addition, this bill will increase the public's role in providing
feedback on the significant changes soon to be implemented in the
Medicaid delivery system. Active monitoring by stakeholders is
increasingly important as both amendments to state law and federal
health reform lead to increased enrollment in managed care and the
implementation of new service delivery models for an increasingly
diverse beneficiary population.

LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS:
None to the state.


EFFECTIVE DATE:
Immediately.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6065

                            I N  S E N A T E

                               (PREFILED)

                             January 4, 2012
                               ___________

Introduced  by Sens. HANNON, DeFRANCISCO, GALLIVAN, LAVALLE, RANZENHOFER
  -- read twice and ordered printed, and when printed to be committed to
  the Committee on Health

AN ACT to amend the social services law,  in  relation  to  the  special
  advisory review panel on Medicaid managed care

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 364-jj of the social  services  law,  as  added  by
chapter 649 of the laws of 1996, is amended to read as follows:
  S 364-jj. Special advisory review panel on Medicaid managed care.
  (a)  There  is  hereby  established a special advisory review panel on
Medicaid managed care AND  RELATED  PUBLIC  HEALTH  INSURANCE  PROGRAMS,
INCLUDING  CHILD HEALTH PLUS, FAMILY HEALTH PLUS, MANAGED LONG TERM CARE
PROGRAMS AND RELATED CARE COORDINATION  MODELS,  MANAGED  CARE  PROGRAMS
DIRECTED  AT COORDINATING CARE FOR DUALLY ELIGIBLE MEDICAID AND MEDICARE
ENROLLEES, AND OTHER PUBLIC HEALTH COVERAGE  CARE  MANAGEMENT  PROGRAMS,
INCLUDING  BUT NOT LIMITED TO HEALTH HOMES AND MEDICAL HOMES.  The panel
shall consist of  [nine]  ELEVEN  members  who  shall  be  appointed  as
follows:  [three]  FIVE by the governor, one of which shall serve as the
chair, TWO OF WHICH SHALL BRING EXPERTISE IN ACCESS ISSUES FACING  MEDI-
CAID CONSUMERS WITH DISABILITIES, AND ONE OF WHICH SHALL BRING EXPERTISE
IN  ACCESS ISSUES FACING CHILDREN, AND ONE SHALL BE A MEDICAID BENEFICI-
ARY; two each by the temporary president of the senate and  the  speaker
of  the  assembly; and one each by the minority leader of the senate and
the minority leader of the assembly. [All members shall be appointed  no
later  than September first, nineteen hundred ninety-six.] Members shall
serve without compensation  but  shall  be  reimbursed  for  appropriate
expenses.   The department shall provide technical assistance and access
to data as is required for the  panel  to  effectuate  the  mission  and
purposes established herein.  THE PANEL SHALL BE REQUIRED TO SEEK PUBLIC
COMMENT  ON  MATTERS WITHIN ITS JURISDICTION. PANEL MEETING TIMES, AGEN-
DAS, AND MINUTES SHALL BE POSTED PUBLICLY ON THE DEPARTMENT'S WEBSITE AT
LEAST ONE WEEK PRIOR TO EACH MEETING.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11134-03-2

S. 6065                             2

  (b) The panel shall MEET NO LESS THAN SIX TIMES PER YEAR,  WITH  ADDI-
TIONAL  SUBCOMMITTEE MEETINGS AS DEEMED NECESSARY TO ADDRESS SPECIALIZED
ISSUES, IN ORDER TO:
  (i)  determine  whether  there  is  sufficient  managed  care provider
participation in the Medicaid managed care program AND RELATED PROGRAMS;
  (ii) determine whether managed care providers meet  proper  enrollment
targets  that  permit  as  many  Medicaid recipients as possible to make
their own health plan decisions, thus minimizing the number of automatic
assignments;
  (iii) review AND DETERMINE THE APPROPRIATENESS OF the phase-in  sched-
ule,  AND  THE  AVAILABILITY  OF SPECIALTY SERVICES for enrollment[,] of
ADDITIONAL POPULATIONS AND managed care providers under both the  volun-
tary and mandatory programs AND EVALUATE STEPS TAKEN TO ENSURE CONTINUI-
TY OF CARE DURING AND AFTER THE TRANSITION;
  (iv)  assess the impact of managed care provider marketing and enroll-
ment  strategies,  [and  the]  INCLUDING  public   education   [campaign
conducted  in  New  York city, on enrollees] CAMPAIGNS, ENROLLEE partic-
ipation in Medicaid managed care plans AND RELATED PROGRAMS;
  (v) evaluate the adequacy of managed care provider capacity by review-
ing established capacity measurements and monitoring  actual  access  to
plan practitioners, INCLUDING TIMELY ACCESS TO SPECIALTY CARE FOR PEOPLE
WITH  DISABILITIES  AND  OTHERS  IN  NEED  OF SUCH CARE, WITH PARTICULAR
ATTENTION TO CAPACITY FOR SERVICES PREVIOUSLY  PROVIDED  IN  THE  TRADI-
TIONAL FEE FOR SERVICE ENVIRONMENT;
  (vi)  examine  the  [cost]  implications  of [populations excluded and
exempted from Medicaid managed care; and] FEDERAL HEALTH CARE REFORM  ON
THE  MEDICAID MANAGED CARE PROGRAM AND RELATED PROGRAMS, WITH PARTICULAR
ATTENTION TO THE INTEGRATION OF PUBLIC PROGRAM FUNCTIONS WITH SUBSIDIZED
PRODUCTS AVAILABLE IN ANY POTENTIAL STATE  INSURANCE  EXCHANGE  AND  ANY
OTHER SUBSIDIZED PRODUCTS, SUCH AS A BASIC HEALTH PLAN;
  (vii)  EVALUATE  TRENDS  IN  SERVICE  DENIALS BY MEDICAID MANAGED CARE
PLANS AND RELATED PROGRAMS, ASSESS EFFECTIVENESS OF GRIEVANCE AND APPEAL
MECHANISMS FOR CONSUMERS;
  (VIII) EVALUATE DATA COLLECTION AND REPORTING ON  HEALTH  CARE  ACCESS
AND  QUALITY  BY RACE, ETHNICITY, LANGUAGE, DISABILITY AND OTHER FACTORS
AND THE AVAILABILITY OF SERVICES AND PROGRAMS THAT ADDRESS THE  DISPARI-
TIES IN ACCESS TO CARE AND OUTCOMES OF CARE;
  (IX) EVALUATE IMPLEMENTATION OF CONSUMER PROTECTIONS;
  (X)  REVIEW WAIVER APPLICATIONS BEFORE ANY DRAFT PROPOSALS ARE SUBMIT-
TED TO THE FEDERAL GOVERNMENT AND AMENDMENTS AND STATE  PLAN  AMENDMENTS
RELATED  TO  TOPICS  AND  PROGRAMS  WITHIN ITS JURISDICTION, AND SOLICIT
PUBLIC INVOLVEMENT IN THE PROPOSALS; AND
  (XI) examine other issues as it deems appropriate.
  (c) Commencing January  first,  [nineteen  hundred  ninety-seven]  TWO
THOUSAND  THIRTEEN  and  quarterly  thereafter the panel shall [submit a
report regarding the status of Medicaid managed care in  the  state  and
provide recommendations if it] PROVIDE WRITTEN RECOMMENDATIONS AND INPUT
AS IT deems appropriate to the governor, the temporary president and the
minority  leader  of the senate, and the speaker and the minority leader
of the assembly ON MATTERS WITHIN ITS JURISDICTION.
  S 2. This act shall take effect immediately.

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.