Relates to the special advisory review panel on Medicaid managed care

BILL NUMBER:S5896A

Title of bill

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

Purpose or general idea of bill

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

Summary of specific 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, review of the federal waiver, as well as public information for choosing among managed long term care plans.

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.

Prior legislative history

2011-2012: A.7651-A passed Assembly

Fiscal implications

None to the state

Effective date

Immediately