45th legislature - STATE OF NEW MEXICO - second session, 2002
RELATING TO THE PUBLIC PEACE, HEALTH, SAFETY AND WELFARE; REQUIRING SUBMISSION OF A REQUEST FOR A NEW MEDICAID WAIVER PROGRAM WITH BENEFITS IN LINE WITH OTHER STATE HEALTH INSURANCE PROGRAMS; CREATING A MEDICAID REFORM COMMITTEE REQUIRED TO MAKE RECOMMENDATIONS BY SEPTEMBER 2002; REQUIRING SUBMISSION OF A REQUEST FOR A NEW MEDICAID WAIVER PROGRAM FOLLOWING THE 2003 LEGISLATIVE SESSION; AMENDING, REPEALING AND ENACTING CERTAIN SECTIONS OF THE NMSA 1978; MAKING AN APPROPRIATION; DECLARING AN EMERGENCY.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
Section 1. Section 27-2B-15 NMSA 1978 (being Laws 1998, Chapter 8, Section 15 and Laws 1998, Chapter 9, Section 15, as amended by Laws 2001, Chapter 295, Section 8 and by Laws 2001, Chapter 326, Section 8) is amended to read:
"27-2B-15. MEDICAID ELIGIBILITY.--
A. The following are eligible for medicaid or a program pursuant to a waiver under Title 19 or 21 of the federal act as created under Section 27-2B-15.1 or 27-2B-15.2 NMSA 1978:
(1) a participant who is in transition to self-sufficiency due to employment or child support;
(2) a pregnant woman who meets the income and resource requirements for New Mexico's aid to families with dependent children as they existed on July 16, 1996;
(3) a member of a benefit group who is eighteen years of age or younger if the benefit group's income is below one hundred eighty-five percent of the federal poverty guidelines or a higher income level as may be permitted pursuant to a waiver under Title 19 or 21 of the federal act as created under Section 27-2B-15.1 or 27-2B-15.2 NMSA 1978;
(4) a pregnant woman whose income is below one hundred eighty-five percent of the federal poverty guidelines;
(5) participants receiving federal supplemental security income;
(6) an aged, blind or disabled person in an
institution who meets all the supplemental security income
standards [except for income];
(7) a person who meets all standards for institutional care but is cared for at home and meets eligibility standards for medicaid;
(8) a qualified medicare beneficiary, qualified disabled working person or specified low-income medicare beneficiary; and
(9) a foster child in the custody of the state or of an Indian pueblo, tribe or nation who meets eligibility standards for medicare.
B. Effective October 1, 2001, for the medicaid
category designated "JUL medicaid" by the department, the
income eligibility criteria shall be the same as the income
eligibility criteria set forth in the New Mexico Works Act."
Section 2. A new section of the Public Assistance Act, Section 27-2B-15.1 NMSA 1978, is enacted to read:
"27-2B-15.1. [NEW MATERIAL] WAIVER REQUEST.--The department shall submit a request for a waiver, no later than May 1, 2002, to the federal health and human services department to provide a program for participants with eligibility levels above the minimum federal levels. The benefits of this program shall be substantially equivalent to those benefits available to employees of the state and public schools pursuant to the Health Care Purchasing Act."
Section 3. A new section of the Public Assistance Act, Section 27-2B-15.2 NMSA 1978, is enacted to read:
"27-2B-15.2. [NEW MATERIAL] WAIVER REQUEST.--The department shall submit a request for a waiver, no later than May 1, 2003, to the federal health and human services department to provide a medicaid benefit program for participants, which benefits shall be based on legislation enacted by the first session of the forty-sixth legislature."
Section 4. TEMPORARY PROVISION--MEDICAID REFORM COMMITTEE CREATED.--There is created a joint interim legislative committee that shall be known as the "medicaid reform committee". The committee shall function from the date of its appointment until the first day of December prior to the first session of the forty-sixth legislature.
Section 5. TEMPORARY PROVISION--MEMBERSHIP--ADVISORY MEMBERS--APPOINTMENT--VACANCIES.--
A. The medicaid reform committee shall be composed of twelve members. Six members of the house of representatives shall be appointed, three appointed by the speaker of the house of representatives and three appointed by the minority leader of the house of representatives. Six members of the senate shall be appointed by the committees' committee of the senate or, if the appointments are made in the interim, by the president pro tempore of the senate after consultation with and agreement of a majority of the members of the committees' committee.
B. Vacancies on the medicaid reform committee shall be filled by appointment in the same manner as the original appointments. The chairman and vice chairman of the committee shall be elected by the committee.
C. An eighteen-member medicaid advisory group comprised of experts in medicaid or health care shall assist and advise the medicaid reform committee. The governor, the speaker of the house of representatives and the president pro tempore of the senate shall each appoint six members to the medicaid advisory group. The governor, the speaker and the president pro tempore shall coordinate their appointments to ensure representation from the following groups: health care and legal consumer advocates; community-based providers; mental and behavioral health providers; health care information management organizations; health care financial management organizations; health care payers and insurers; hospitals and other institutional providers; and physicians, nurses and other health care professionals.
D. No action shall be taken by the committee if a majority of the total membership from either house on the committee rejects such action.
Section 6. TEMPORARY PROVISION--DUTIES.--
A. After its appointment, the medicaid reform committee shall hold one organizational meeting to develop a work plan and budget for the ensuing interim.
B. In developing the work plan, the medicaid reform committee shall take into consideration current resources and projected needs for the state medicaid program's services, delivery, funding and policy, including:
(1) the current operating structure of the medicaid programs in New Mexico;
(2) the level of oversight authority necessary for the medicaid-related divisions of the human services department and health care payer and provider contractors under the medicaid program;
(3) the operational structure of the state medicaid program, with respect to how policy and fiscal determinations are made;
(4) the concerns and recommendations regarding the operation of the medicaid program made by other interim legislative committees, consumer advocates, health care providers, health care payers or their respective organizations;
(5) the allocation of health care costs and funding sources to avoid or eliminate unnecessary cost-shifting;
(6) the geographic distribution of health care professionals, resources and programs in the state medicaid program and of public-private partnerships to address health care access, delivery and funding issues that are problematic for both employers and employees; and
(7) the available federal, state and local sources of funding for the state medicaid program.
C. The medicaid reform committee shall solicit public input.
D. The work plan and budget shall be submitted to the New Mexico legislative council for approval. Upon approval of the work plan and budget by the council, the medicaid reform committee shall examine the statutes, constitutional provisions, regulations and court decisions governing the state medicaid program and related health care programs and services and recommend legislation or changes.
Section 7. TEMPORARY PROVISION--SUBCOMMITTEES.--Subcommittees shall be created only by majority vote of all members appointed to the medicaid reform committee and with the prior approval of the New Mexico legislative council. A subcommittee shall be composed of at least one member from the senate and one member from the house of representatives, and at least one member of the minority party shall be a member of the subcommittee. All meetings and expenditures of a subcommittee shall be approved by the full committee in advance of such meeting or expenditure, and the approval shall be shown in the minutes of the committee.
Section 8. TEMPORARY PROVISION--REPORT.--The medicaid reform committee shall make a report of its findings and recommendations for the consideration of the legislature. The report and suggested legislation shall be made available to the New Mexico legislative council by September 1, 2002.
Section 9. TEMPORARY PROVISION--STAFF.--The staff for the medicaid reform committee shall be provided by the legislative council service.
Section 10. APPROPRIATION.--Two hundred fifty thousand dollars ($250,000) is appropriated from the legislative council service cash balances to the legislative council service for expenditure in fiscal years 2002 and 2003 to pay for technical and legal assistance and for necessary equipment and supplies used in carrying out the provisions of this act and for reimbursing the per diem and mileage expenses of the committee. Any unexpended or unencumbered balance remaining at the end of fiscal year 2003 shall revert to the legislative council service cash balances. Payments from the appropriation shall be made upon vouchers signed by the director of the legislative council service or his authorized representative.
Section 11. DELAYED REPEAL.--Effective July 1, 2003, Section 27-2B-15.1 NMSA 1978 (being Section 2 of this act) is repealed.
Section 12. EMERGENCY.--It is necessary for the public peace, health and safety that this act take effect immediately.