SENATE JOINT MEMORIAL 9

49th legislature - STATE OF NEW MEXICO - second session, 2010

INTRODUCED BY

Dede Feldman

A JOINT MEMORIAL

REQUESTING NEW MEXICO'S PUBLIC AND QUASI-PUBLIC HEALTH CARE COVERAGE ENTITIES TO CONSOLIDATE CERTAIN ADMINISTRATIVE FUNCTIONS AND ACHIEVE COST SAVINGS.

     WHEREAS, the general services department, the retiree health care authority, the public school insurance authority and the Albuquerque public schools belong to an interagency benefits advisory committee, which cooperates to issue a common request for proposals for health care benefits for their respective entities; and

     WHEREAS, the New Mexico health insurance alliance is a nonprofit health care entity made up of health insurance companies, nonprofit health care plans, health maintenance organizations and self-insurers organized to offer health insurance to small employers in the state; and

     WHEREAS, the human services department administers its state coverage insurance program as a medical assistance program to provide health insurance to low-income adults; and

     WHEREAS, the human services department also administers the premium assistance for kids program and the premium assistance for maternity program, which pay a portion of the premiums for private comprehensive health insurance for eligible children and pregnant women, respectively; and

     WHEREAS, the New Mexico medical insurance pool is a program that provides access to health insurance coverage to individuals who have been denied health insurance elsewhere because they are considered to be too high risk for other insurance products; and

     WHEREAS, these public and quasi-public health care coverage entities provide comprehensive health coverage for approximately two hundred fifty thousand individuals, or approximately thirteen percent of New Mexico's residents; and

     WHEREAS, in response to a request by the New Mexico legislature in Senate Joint Memorial 1 in 2009, representatives from these public and quasi-public health care coverage entities met to identify areas of common interest and opportunities for consolidation; and

     WHEREAS, these representatives presented a series of recommendations pursuant to Senate Joint Memorial 1 to the interim legislative health and human services committee in November 2009, including that those entities:

          A. create an all-payer claims database;

          B. use one third-party administrator or an administrative-services-only contract;

          C. implement an electronic common enrollment process, which would enhance speed and efficiency and use joint referral processes and procedures;

          D. determine a common data reporting year and a common plan year;

          E. link their web sites to facilitate information-sharing;

          F. conduct joint outreach and marketing efforts;

          G. enter into a common contract for actuarial services to perform a cost-benefit analysis of further consolidation of these entities' health care procurement, purchasing and administration;

          H. enter into a common contract for actuarial services for their plans;

          I. implement joint broker certification for the New Mexico health insurance alliance, state coverage insurance and New Mexico medical insurance pool programs, with the insurance division of the public regulation commission awarding continuing education units to brokers; and

          J. move toward common benefit plan design;

     NOW, THEREFORE, BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO that representatives of New Mexico's public and quasi-public health care coverage entities be requested to continue to meet and develop a common plan to:

          A. implement an all-payer claims database;

          B. use one third-party administrator or administrative-services-only contract for all of these entities combined;

          C. implement an electronic common enrollment process to enhance speed and efficiency and use joint referral processes and procedures;

          D. determine among the entities a common data reporting year and a common plan year;

          E. link their web sites to facilitate information-sharing;

          F. conduct joint outreach and marketing efforts;

          G. enter into a common contract for actuarial services to perform a cost-benefit analysis of further consolidation of these entities' health care procurement, purchasing and administration; and

          H. enter into a common contract for actuarial services for their plans; and

     BE IT FURTHER RESOLVED that the New Mexico health insurance alliance, state coverage insurance program and New Mexico medical insurance pool be requested to implement joint broker certification; and

     BE IT FURTHER RESOLVED that the insurance division of the public regulation commission be requested to award continuing education units to brokers for the New Mexico health insurance alliance, state coverage insurance and New Mexico medical insurance pool programs; and

     BE IT FURTHER RESOLVED that the public and quasi-public health care coverage entities be requested to move toward a common benefit plan design; and

     BE IT FURTHER RESOLVED that representatives from these public and quasi-public health care coverage entities be requested to report the details of and implementation strategy for the common plan that they have developed pursuant to the requests made in this memorial before the legislative health and human services committee and the legislative finance committee by December 1, 2010; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the secretary of general services; the secretary of human services; the superintendent of insurance; the executive director of the New Mexico medical insurance pool; the executive director of the retiree health care authority; the executive director of the public school insurance authority; and the superintendent of Albuquerque public schools.

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