Requires additional medicaid recipients throughout the state to participate in managed care plans

Title of bill

An act to amend the social services law, in relation to mandatory managed care for certain recipients of medical assistance

Purpose of the bill

This bill would require additional Medicaid recipients, throughout the State, to participate in managed care plans.

Summary of specific provisions

§ 1- Amends Paragraph (b) of subdivision 1 of § 364-j of the Social Services Law to include rural health networks and those providers who hold a comprehensive HIV special needs plan certificate of authority as managed care providers.

§ 2- Amends paragraph (g) of subdivision 3 of § 364-j of the Social Services Law to expand the categories of individuals who are required to enroll with a managed care program. Specifically, this bill would require that the following categories of individuals be enrolled in managed care programs: persons who are dually eligible for Medicaid and Medicare and who are enrolled in a TEFRA plans; persons who are eligible for S.S.I.; persons who are HIV positive; or persons with serious mental illness and children and adolescents with serious emotional disturbances be enrolled in managed care programs.

§ 3- Amends § 364-j of the Social Services Law to authorize the Commissioner of Health to take all necessary measures to cause all social services districts in the state not already doing so to provide Medicaid services and implement the State's managed care program. In addition, this section authorizes the Commissioner of Health to submit all appropriate waivers to implement this plan.

§ 4- Stipulates that § 2 of this act shall not take effect unless and until the Commissioner of Health receives all necessary approvals under federal law .

§ 5- Effective date.

Justification

While implementing cost containment measures, managed care programs incorporate comprehensive consumer protections to ensure that all recipients obtain enrollment assistance and quality care, and understand their rights and responsibilities under the managed care plan. This bill expands the definition of managed care providers, requires that all areas of the State provide Medicaid managed care programs, and expands the categories of individuals who are required to enroll in the programs.

Prior legislative history

2007-2008: A.4673/S.3296 2005-2006: A.5461/S.3541

Fiscal implications

Yet to be determined. Cost savings to both counties and the State are expected.

Effective date

This act shall take effect immediately.