Bill No.:                      SF0060                                    Drafter:  JWL

LSO No.:                    13LSO-0338                           Effective Date:  3/15/2013

Enrolled Act No.:      SEA0082

Chapter No.:              CH0117

Prime Sponsor:          Joint Labor, Health & Social Services Interim Committee

Catch Title:                Medicaid reform.

Subject:                      Authorizes and provides direction to Department of Health for specified Medicaid reforms.

Summary/Major Elements:

· This act directs the Department of Health to proceed with a reform and redesign of the Medicaid program as studied pursuant to 2012 legislation.  Significant items to be implemented include:

o Incentives for healthy lifestyles, measurable performance outcomes and decreased use of emergency rooms;

o Increased managed care with differential tiers of service;

o Expansion of prenatal services for all women whose children are likely to be Medicaid-eligible;

o Increased fraud prevention;

o Use of a capitated payment model instead of fee-for-service;

o Increasing the number of waiver clients by offering services based on individual client needs and individual budget amounts;

o Replacement whenever possible of high-cost residential services with lower-cost, community-integrated services.

· The act requires at least two informational meetings for input from clients, guardians and service providers.

· The act authorizes the department to contract with experts and consultants, and exempts the department from state procurement requirements for purposes of this act.

Comments:

· Status reports required from Department of Health to the Joint Labor, Health & Social Services Interim Committee by October 1, 2013 and October 1, 2014.