0001| SENATE BILL 198
|
0002| 42ND LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION,
|
0003| 1996
|
0004| INTRODUCED BY
|
0005| JANICE D. PASTER
|
0006|
|
0007|
|
0008|
|
0009| FOR THE HEALTH CARE TASK FORCE
|
0010|
|
0011| AN ACT
|
0012| RELATING TO HEALTH CARE; ENACTING THE MEDICAID REVIEW ACT;
|
0013| REQUIRING REVIEW OF THE SERVICES AND MEDICAL BENEFITS PROVIDED
|
0014| IN THE MEDICAID PROGRAM; AUTHORIZING REVISIONS TO THE MEDICAID
|
0015| PROGRAM; MAKING APPROPRIATIONS; DECLARING AN EMERGENCY.
|
0016|
|
0017| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
|
0018| Section 1. SHORT TITLE.--Sections 1 through 4 of this act
|
0019| may be cited as the "Medicaid Review Act".
|
0020| Section 2. PURPOSE OF ACT.--The purpose of the Medicaid
|
0021| Review Act is to ensure that the human services department
|
0022| reviews, with full public involvement, the medicaid program and
|
0023| the full array of services and medical benefits provided in the
|
0024| medicaid program.
|
0025| Section 3. HUMAN SERVICES DEPARTMENT REVIEW OF MEDICAID
|
0001| BENEFITS AND SERVICES.--
|
0002| A. The human services department, in consultation
|
0003| with other state agencies using medicaid funds, shall conduct a
|
0004| review that considers the full array of services and medical
|
0005| benefits provided in the medicaid program. The public review
|
0006| process provided in the Medicaid Review Act shall be used by the
|
0007| department to assist it in planning the medicaid program and in
|
0008| developing recommendations for funding to the state legislature.
|
0009| B. In conducting the review, the department shall
|
0010| seek to develop through a broad-based public process a consensus
|
0011| on values to guide medicaid spending and medicaid resource
|
0012| allocation. The review shall consider all medicaid services,
|
0013| including:
|
0014| (1) medical benefits;
|
0015| (2) nursing facilities and home- and community-based services;
|
0016| (3) institutional, home- and community-based
|
0017| care for the developmentally disabled, the chronically mentally
|
0018| ill or emotionally disturbed and the treatment of alcohol- and
|
0019| drug-dependent persons; and
|
0020| (4) other categories of service.
|
0021| C. The public review process shall include a series
|
0022| of public hearings and seek testimony and information from a
|
0023| wide range of interested persons, including legislative and
|
0024| executive representatives, advocates for seniors, handicapped
|
0025| persons, mental health consumers, low-income individuals and
|
0001| providers of services or potential services for the medicaid
|
0002| program.
|
0003| D. Unless otherwise provided in the Medicaid Review
|
0004| Act, the human services department may establish committees or
|
0005| advisory groups as it deems necessary or appropriate to conduct
|
0006| the review required by this section and make recommendations to
|
0007| the department; provided that the membership of any such
|
0008| committee or advisory group shall reflect the ethnic, economic
|
0009| and geographic diversity of New Mexico.
|
0010| E. The human services department shall work with the
|
0011| New Mexico health policy commission to establish a subcommittee
|
0012| to review medical benefits for the medicaid program. The New
|
0013| Mexico health policy commission shall administer and oversee the
|
0014| work of the subcommittee. The subcommittee shall participate in
|
0015| the public review process and shall:
|
0016| (1) recommend to the human services department
|
0017| the array of medical benefits for the medicaid program. The
|
0018| subcommittee shall accord priority attention to providing basic
|
0019| preventive and primary care medical benefits to all persons
|
0020| eligible for medicaid assistance. The advantages of each
|
0021| medical benefit to the population to be served by the medicaid
|
0022| program shall be described;
|
0023| (2) consider eligibility criteria for medical
|
0024| benefits for medicaid recipients; and
|
0025| (3) consider patient co-payments and
|
0001| appropriate reimbursement rates for medical benefits for
|
0002| providers and plans that serve medicaid recipients.
|
0003| F. The human services department shall consider
|
0004| opinions expressed in the public review process required in the
|
0005| Medicaid Review Act and recommendations of committees, advisory
|
0006| groups and the medical benefits subcommittee prior to issuing
|
0007| proposed regulations to revise the medicaid program.
|
0008| G. In conducting its review, the human services
|
0009| department shall adopt interim revisions to the medicaid program
|
0010| if necessary to comply with federal law requirements imposed for
|
0011| calendar year 1996; provided the department shall seek, to the
|
0012| maximum extent practicable, to include public participation and
|
0013| comment prior to the adoption of interim regulations for 1996.
|
0014| The department shall complete its review of the medicaid program
|
0015| by October 1, 1997, and shall revise that review by October 1,
|
0016| 1998, in accordance with the provisions of the Medicaid Review
|
0017| Act.
|
0018| H. The human services department shall submit a
|
0019| report to the appropriate interim legislative committee by
|
0020| October 1, 1997, and revise the report by October 1, 1998, of
|
0021| the department's review of and recommendations concerning
|
0022| services and the allocation of funds for the medicaid program.
|
0023| Section 4. AUTHORIZATION FOR CONTRACTS--NOTICE TO
|
0024| PROVIDERS.--
|
0025| A. The New Mexico health policy commission and the
|
0001| human services department may enter into contracts to hire
|
0002| actuaries, consultants and experts as they deem necessary or
|
0003| appropriate to fulfill the duties of the Medicaid Review Act.
|
0004| B. Providers of services under medicaid and health
|
0005| plans contracting with the human services department for
|
0006| medicaid services shall be given thirty days' written notice
|
0007| prior to a reduction in reimbursement payments or services
|
0008| taking effect.
|
0009| Section 5. APPROPRIATIONS.--
|
0010| A. One hundred fifty thousand dollars ($150,000) is
|
0011| appropriated from the general fund to the New Mexico health
|
0012| policy commission for expenditure in fiscal years 1997 through
|
0013| 1999 to perform the duties required in the Medicaid Review Act.
|
0014| Any unexpended or unencumbered balance remaining at the end of
|
0015| fiscal year 1999 shall revert to the general fund.
|
0016| B. Two hundred thousand dollars ($200,000) is
|
0017| appropriated from the general fund to the human services
|
0018| department for expenditure in fiscal years 1997 through 1999 for
|
0019| the purpose of performing the duties required in the Medicaid
|
0020| Review Act. Any unexpended or unencumbered balance remaining at
|
0021| the end of fiscal year 1999 shall revert to the general fund.
|
0022| Section 6. DELAYED REPEAL.--The Medicaid Review Act is
|
0023| repealed effective October 1, 1998.
|
0024| Section 7. EMERGENCY.--It is necessary for the public
|
0025| peace, health and safety that this act take effect immediately.
|
0001| - 6 -
|
0002|
|
0003| FORTY-SECOND LEGISLATURE
|
0004| SECOND SESSION, 1996
|
0005|
|
0006|
|
0007| JANUARY 24, 1996
|
0008|
|
0009| Mr. President:
|
0010|
|
0011| Your COMMITTEES' COMMITTEE, to whom has been referred
|
0012|
|
0013| SENATE BILL 198
|
0014|
|
0015| has had it under consideration and finds same to be GERMANE, PURSUANT
|
0016| TO CONSTITUTIONAL PROVISIONS, and thence referred to the PUBLIC
|
0017| AFFAIRS COMMITTEE.
|
0018|
|
0019| Respectfully submitted,
|
0020|
|
0021|
|
0022|
|
0023|
|
0024| __________________________________
|
0025| SENATOR MANNY M. ARAGON, Chairman
|
0001|
|
0002|
|
0003|
|
0004| Adopted_______________________ Not Adopted_______________________
|
0005| (Chief Clerk) (Chief Clerk)
|
0006|
|
0007|
|
0008| Date ________________________
|
0009|
|
0010|
|
0011|
|
0012| S0198CC1
|
0013|
|
0014| FORTY-SECOND LEGISLATURE SB 198/a
|
0015| SECOND SESSION, 1996
|
0016|
|
0017|
|
0018| February 5, 1996
|
0019|
|
0020| Mr. President:
|
0021|
|
0022| Your PUBLIC AFFAIRS COMMITTEE, to whom has been referred
|
0023|
|
0024| SENATE BILL 198
|
0025|
|
0001| has had it under consideration and reports same with recommendation that
|
0002| it DO PASS, amended as follows:
|
0003|
|
0004| 1. On page 1, lines 13 and 14, strike "AUTHORIZING REVISIONS TO
|
0005| THE MEDICAID PROGRAM;".
|
0006|
|
0007| 2. On page 1, line 23, after "program" and before the period
|
0008| insert "and seeks appropriate legislative approval for significant
|
0009| changes in services, medical benefits or eligibility criteria made to
|
0010| the program".
|
0011|
|
0012| 3. On page 2, between lines 20 and 21, insert the following new
|
0013| subsections to read:
|
0014|
|
0015| "C. In conducting the review, the department
|
0016| shall analyze the impact to other health services of recommended changes
|
0017| to the medicaid program including:
|
0018|
|
0019| (1) costs incurred by the state, county indigent funds
|
0020| and private insurance providers and policyholders;
|
0021|
|
0022| (2) costs of uncompensated care incurred by providers;
|
0023|
|
0024| (3) use of emergency care;
|
0025|
|
0001| (4) care received by persons affected by proposed changes
|
0002| in services, eligibility criteria or the imposition of co-payment
|
0003| requirements;
|
0004|
|
0005| (5) care received by special needs populations and
|
0006| persons with terminal or progressive illnesses; and
|
0007|
|
0008| (6) rural health care infrastructure and provider
|
0009| participation in the medicaid program.
|
0010|
|
0011| D. The review of the medicaid program by the department shall
|
0012| include consideration of options to contain health care costs and expand
|
0013| medicaid coverage to persons without health insurance.".
|
0014|
|
0015| 4. Reletter the succeeding subsections accordingly.
|
0016|
|
0017| 5. On page 3, line 20, after "assistance" and before the period
|
0018| insert, ", taking into account special needs populations and persons
|
0019| with terminal illness".
|
0020|
|
0021| 6. On page 4, line 7, after "program" and before the period
|
0022| insert, "or seeking legislative approval for significant changes in
|
0023| services, medical benefits or eligibility in the medicaid program".
|
0024|
|
0025| 7. On page 5, line 6, after "given" insert "no less than".,
|
0001|
|
0002| and thence referred to the FINANCE COMMITTEE.
|
0003|
|
0004| Respectfully submitted,
|
0005|
|
0006|
|
0007|
|
0008| __________________________________
|
0009| Shannon Robinson, Chairman
|
0010|
|
0011|
|
0012|
|
0013| Adopted_______________________ Not Adopted_______________________
|
0014| (Chief Clerk) (Chief Clerk)
|
0015|
|
0016|
|
0017| Date ________________________
|
0018|
|
0019|
|
0020| The roll call vote was 5 For 0 Against
|
0021| Yes: 5
|
0022| No: 0
|
0023| Excused: Naranjo, E. Jennings, Wiener
|
0024| Absent: None
|
0025|
|
0001|
|
0002| S0198PA1 .110599.2
|
0003|
|
0004|
|
0005|
|
0006|
|
0007| FORTY-SECOND LEGISLATURE SB 198/a
|
0008| SECOND SESSION, 1996
|
0009|
|
0010|
|
0011| February 8, 1996
|
0012|
|
0013| Mr. President:
|
0014|
|
0015| Your FINANCE COMMITTEE, to whom has been referred
|
0016|
|
0017| SENATE BILL 198, as amended
|
0018|
|
0019| has had it under consideration and reports same with recommendation that
|
0020| it DO PASS, amended as follows:
|
0021|
|
0022| 1. On page 1, line 14, strike "MAKING APPROPRIATIONS;".
|
0023|
|
0024| 2. On page 5, strike lines 9 through 21 in their entirety.
|
0025|
|
0001| 3. Renumber the succeeding sections accordingly.
|
0002|
|
0003|
|
0004| Respectfully submitted,
|
0005|
|
0006|
|
0007|
|
0008| __________________________________
|
0009| Ben D. Altamirano, Chairman
|
0010|
|
0011|
|
0012|
|
0013| Adopted_______________________ Not Adopted_______________________
|
0014| (Chief Clerk) (Chief Clerk)
|
0015|
|
0016|
|
0017| Date ________________________
|
0018|
|
0019|
|
0020| The roll call vote was 8 For 0 Against
|
0021| Yes: 8
|
0022| No: 0
|
0023| Excused: Aragon, Ingle, Jennings T., Kidd, Kysar
|
0024| Absent: None
|
0025|
|
0001|
|
0002| S0198FC1 .111958.1
|
0003|
|
0004| State of New Mexico
|
0005| House of Representatives
|
0006|
|
0007| FORTY-SECOND LEGISLATURE
|
0008| SECOND SESSION, 1996
|
0009|
|
0010|
|
0011| February 14, 1996
|
0012|
|
0013|
|
0014| Mr. Speaker:
|
0015|
|
0016| Your APPROPRIATIONS AND FINANCE COMMITTEE, to whom has
|
0017| been referred
|
0018|
|
0019| SENATE BILL 198, as amended
|
0020|
|
0021| has had it under consideration and reports same with
|
0022| recommendation that it DO PASS.
|
0023|
|
0024| Respectfully submitted,
|
0025|
|
0001|
|
0002|
|
0003|
|
0004| Max Coll, Chairman
|
0005|
|
0006|
|
0007| Adopted Not Adopted
|
0008| (Chief Clerk) (Chief Clerk)
|
0009|
|
0010| Date
|
0011|
|
0012| The roll call vote was 15 For 2 Against
|
0013| Yes: 15
|
0014| No: Bird, Wallace
|
0015| Excused: Light
|
0016| Absent: None
|
0017|
|
0018|
|
0019|
|
0020| S0198AF1
|