0001| HOUSE JOINT MEMORIAL 19
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0002| 42ND LEGISLATURE - STATE OF NEW MEXICO - SECOND
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0003| SESSION, 1996
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0004| INTRODUCED BY
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0005| JOSE R. ABEYTA
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0007|
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0008|
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0009| FOR THE HEALTH CARE TASK FORCE
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0010|
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0011| A JOINT MEMORIAL
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0012| REQUESTING THAT THE HUMAN SERVICES DEPARTMENT, IN CONJUNCTION
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0013| WITH THE DEPARTMENT OF HEALTH AND THE CHILDREN, YOUTH AND
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0014| FAMILIES DEPARTMENT, REPORT ON ISSUES CONCERNING THE MEDICAID
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0015| MANAGED CARE PROGRAM.
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0016|
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0017| WHEREAS, the human services department implemented the
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0018| primary care network in 1991 as an initial managed care delivery
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0019| system to control, in part, the cost of health services for
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0020| Medicaid recipients; and
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0021| WHEREAS, under the primary care network program, medicaid
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0022| recipients receive routine health care services from a selected
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0023| primary care provider who manages the provision of specialist
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0024| services, inpatient and outpatient hospital services and most
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0025| ambulatory services for medicaid recipients; and
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0001| WHEREAS, in 1994, the state legislature mandated the use of
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0002| a managed care system for delivery of services to Medicaid
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0003| recipients by 1995 to help improve program efficiency and access
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0004| to care for low-income populations by managing the
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0005| beneficiaries' care and ensuring that services are integrated
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0006| and coordinated to promote early intervention and preventive
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0007| care; and
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0008| WHEREAS, while statewide implementation of the primary care
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0009| network may meet the legislative mandate for the use of a
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0010| managed care system for medicaid recipients, the human services
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0011| department determined that additional managed care delivery
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0012| services should be developed and implemented for the medicaid
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0013| population; and
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0014| WHEREAS, the human services department hired the health
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0015| care consulting firm of Lewin-VFI, Inc. to serve as the managed
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0016| care consultant to assist the department in the development of a
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0017| managed care delivery system for the medicaid population; and
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0018| WHEREAS, recommendations outlined by the human services
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0019| department state that the majority of services furnished to
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0020| medicaid recipients will be provided in a managed care
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0021| environment, the majority of medicaid eligible recipients will
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0022| be required to enroll in a health maintenance organization or
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0023| managed care system and the development of managed care models
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0024| for additional services will be determined by a collaborative
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0025| effort between the appropriate state executive agency
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0001| departments, provider groups, advocacy groups and medicaid
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0002| recipients;
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0003| NOW, THEREFORE, BE IT RESOLVED BY THE LEGISLATURE OF THE
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0004| STATE OF NEW MEXICO that the human services department, in
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0005| conjunction with the department of health and the children,
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0006| youth and families department report to the appropriate interim
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0007| legislative health care committee by September 1, 1996 on the
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0008| status of the medicaid managed care planning process to include
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0009| the following issues concerning the implementation of that
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0010| planning process:
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0011| A. the extent to which integrated networks of
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0012| appropriately trained, high quality direct service providers are
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0013| available throughout the state, including whether the managed
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0014| care program demonstrates a decline in the use of specialist
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0015| services and emergency rooms as service sites and whether
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0016| managed care increases or decreases the number of physician
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0017| visits or the use of inpatient hospital care;
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0018| B. the extent to which an information system has
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0019| been established to track all health system encounters that will
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0020| enhance integration and coordination of services while
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0021| protecting individual patient confidentiality;
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0022| C. the ability of the human services department to
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0023| track and adjust the performance of provider networks within the
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0024| managed care system to assure comprehensive, continuous health
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0025| care services, appropriate access to needed levels of care,
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0001| protection of programs for vulnerable populations and prompt
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0002| medical decisions within a utilization review framework;
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0003| D. the scope and effectiveness of a quality
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0004| assurance program that promotes public accountability and
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0005| assesses the impact of the medicaid managed care program on the
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0006| quality of health care delivered;
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0007| E. the financial stability of the medicaid managed
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0008| care program, including the impact of the program on health care
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0009| costs relative to traditional fee-for-service programs;
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0010| F. the extent to which consumers are fully informed
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0011| concerning their ability to utilize and access services under a
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0012| managed care program as well as the ability of consumers to
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0013| pursue grievances;
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0014| G. the extent to which communities participate in
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0015| the design and implementation of local integrated networks
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0016| within the managed care program regarding local health care
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0017| needs;
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0018| H. the extent to which health promotion and disease
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0019| prevention strategies have been developed and implemented;
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0020| I. the extent to which performance standards that
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0021| emphasize recognized health outcomes, service delivery and
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0022| consumer satisfaction regarding overall care provided through a
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0023| managed care program, such as the extent to which choice in
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0024| physician and potential lack of use of health care services have
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0025| been developed and utilized in contracts entered into with a
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0001| managed care organization; and
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0002| J. mechanisms for oversight, protections and
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0003| adequate enforcement to assure managed care contractors are
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0004| fulfilling their obligations to provide quality health services
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0005| within the defined parameters of the medicaid managed care
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0006| program; and
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0007| BE IT FURTHER RESOLVED that a copy of this memorial be sent
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0008| to the secretary of human services, the secretary of health and
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0009| the secretary of children, youth and families.
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0010| - - State of New Mexico
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0011| House of Representatives
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0012|
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0013| FORTY-SECOND LEGISLATURE
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0014| SECOND SESSION, 1996
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0015|
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0016| January 25, l996
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0017|
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0018|
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0019| Mr. Speaker:
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0020|
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0021| Your RULES AND ORDER OF BUSINESS COMMITTEE, to
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0022| whom has been referred
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0023|
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0024| HOUSE JOINT MEMORIAL 19
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0025|
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0001| has had it under consideration and finds same to be
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0002| GERMANE in accordance with constitutional provisions.
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0003|
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0004| Respectfully submitted,
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0005|
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0006|
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0007|
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0008|
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0009| Barbara A. Perea Casey,
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0010| Chairperson
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0011|
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0012|
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0013| Adopted Not Adopted
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0014|
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0015| (Chief Clerk) (Chief Clerk)
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0016|
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0017| Date
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0018|
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0019| The roll call vote was 9 For 1 Against
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0020| Yes: 9
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0021| No: Nicely
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0022| Excused: Luna, Pederson, Rodella, R. G. Sanchez, J. G. Taylor
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0023| Absent: None
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0024|
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0025| HJ019RC1 State of New Mexico
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0001| House of Representatives
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0002|
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0003| FORTY-SECOND LEGISLATURE
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0004| SECOND SESSION, 1996
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0005|
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0006|
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0007| February 6, 1996
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0008|
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0009|
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0010| Mr. Speaker:
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0011|
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0012| Your GOVERNMENT AND URBAN AFFAIRS COMMITTEE, to
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0013| whom has been referred
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0014|
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0015| HOUSE JOINT MEMORIAL 19
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0016|
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0017| has had it under consideration and reports same with
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0018| recommendation that it DO PASS, amended as follows:
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0019|
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0020| 1. On page 3, line 1, after "recipients;" insert "and".
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0021|
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0022| 2. On page 3, between lines 1 and 2, insert the following:
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0023|
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0024| "WHEREAS, the state legislature needs to give prior approval
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0025| to medicaid managed care plans before the implementation of such
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0001| plans by the human services department;".
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0002|
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0003| 3. On page 3, line 13, after "program" strike
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0004| "demonstrates" and insert in lieu thereof "will demonstrate".
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0005|
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0006| 4. On page 4, line 7, strike "including" and insert in
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0007| lieu thereof "and" and after the first occurrence of "the" insert
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0008| "economic".
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0009|
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0010| 5. On page 4, line 8, strike "relative" and insert in lieu
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0011| thereof "including comparisons".
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0012|
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0013| 6. On page 4, line 8, after "programs" insert "and
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0014| universal health care plans".
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0015|
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0016| 7. On page 4, line 9, strike "are" and insert in lieu
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0017| thereof "will be".
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0018|
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0019| 8. On page 4, line 13, after "communities" insert "will".
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0020|
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0021| 9. On page 4, line 18, strike "and implemented".
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0022|
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0023| 10. On page 4, line 24, strike "and utilized" and insert in
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0024| lieu thereof "for utilization".
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0025|
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0001|
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0002|
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0003|
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0004| 11. On page 5, between lines 5 and 6, insert:
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0005|
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0006| "BE IT FURTHER RESOLVED that any proposed medicaid managed
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0007| care plans developed by the human services department, in
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0008| conjunction with the department of health and the children, youth
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0009| and families department, be reported to the appropriate interim
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0010| legislative health care committee and given legislative approval
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0011| before the department of human services implements any medicaid
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0012| managed care plans;".
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0013|
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0014|
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0015|
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0016| and thence referred to the APPROPRIATIONS AND FINANCE
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0017| COMMITTEE.
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0018|
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0019| Respectfully submitted,
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0020|
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0021|
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0022|
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0023|
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0024| Lynda M. Lovejoy, Chairwoman
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0025|
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0001|
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0002| Adopted Not Adopted
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0003|
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0004| (Chief Clerk) (Chief Clerk)
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0005|
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0006| Date
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0007|
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0008| The roll call vote was 5 For 2 Against
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0009| Yes: 5
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0010| No: Hobbs, Macko
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0011| Excused: Gentry, Perls, Roberts, Sanchez, R.R.
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0012| Absent: None
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0013|
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0014|
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0015| .111404.2
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0016|
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0017|
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0018| HJ019GU1
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0019|
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0020|
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0021|
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0022|
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0023|
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0024|
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0025|
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0001| State of New Mexico
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0002| House of Representatives
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0003|
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0004| FORTY-SECOND LEGISLATURE
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0005| SECOND SESSION, 1996
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0006|
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0007|
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0008| February 8, 1996
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0009|
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0010|
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0011| Mr. Speaker:
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0012|
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0013| Your APPROPRIATIONS AND FINANCE COMMITTEE,to
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0014| whom has been referred
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0015|
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0016| HOUSE JOINT MEMORIAL 19, as amended
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0017|
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0018| has had it under consideration and reports same with
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0019| recommendation that it DO PASS.
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0020|
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0021| Respectfully submitted,
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0022|
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0023|
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0024|
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0025|
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0001| Max Coll, Chairman
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0002|
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0003|
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0004| Adopted Not Adopted
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0005|
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0006| (Chief Clerk) (Chief Clerk)
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0007|
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0008| Date
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0009|
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0010| The roll call vote was 10 For 2 Against
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0011| Yes: 10
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0012| No: Bird, Buffett
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0013| Excused: Gentry, Martinez, Reyes, Saavedra, Varela, Watchman
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0014| Absent: none
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0015|
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0016|
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0017|
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0018| HJ019AF1
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0019|
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0020| FORTY-SECOND LEGISLATURE
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0021| SECOND SESSION, 1996
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0022|
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0023|
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0024| February 13, 1996
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0025|
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0001| Mr. President:
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0002|
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0003| Your RULES COMMITTEE, to whom has been referred
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0004|
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0005| HOUSE JOINT MEMORIAL 19, as amended
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0006|
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0007| has had it under consideration and reports same with
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0008| recommendation that it DO PASS.
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0009|
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0010| Respectfully submitted,
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0011|
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0012|
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0013|
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0014| __________________________________
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0015| Gloria Howes, Chairman
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0016|
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0017|
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0018|
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0019| Adopted_______________________ Not Adopted_______________________
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0020| (Chief Clerk) (Chief Clerk)
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0021|
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0022|
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0023|
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0024| Date ________________________
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0025|
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0001|
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0002| The roll call vote was 6 For 0 Against
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0003| Yes: 6
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0004| No: 0
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0005| Excused: EJennings, Donisthorpe, Aragon
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0006| Absent: 0
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0007|
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0008|
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0009| HJO19RU1
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0010|
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