SB 129

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AN ACT

RELATING TO HEALTH CARE REFORM; ESTABLISHING A HEALTHY NEW

MEXICO TASK FORCE TO DEVISE A STRATEGIC PLAN FOR IMPLEMENTING

DISEASE PREVENTION AND CHRONIC CONDITION AND CHRONIC DISEASE

MANAGEMENT MEASURES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

Section 1. TEMPORARY PROVISION--HEALTHY NEW MEXICO TASK

FORCE--MEMBERSHIP--DUTIES.--

A. By July 1, 2008, the secretary of health shall

convene a healthy New Mexico task force to devise a

comprehensive five-year strategic plan for preventing disease

and managing chronic conditions for public and private

programs. The healthy New Mexico task force shall report on

its strategic plan to the interim legislative health and

human services committee by June 30, 2009. The healthy New

Mexico task force shall work in conjunction with the national

institutes of health, the New Mexico health policy

commission, the New Mexico medical society or other boards,

commissions, departments, agencies, authorities,

organizations and persons necessary to provide appropriate

expertise to devise the strategic plan. The strategic plan

shall contain recommendations for reducing overall demand for

high-cost medical and behavioral health treatments, thereby

reducing or moderating the increase in health care costs.

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B. The healthy New Mexico task force's strategic

plan shall include the following features:

(1) a plan for hiring the services of

persons specializing in disease management to control costs

and encourage healthy lifestyles in the state employees group

benefits self-insurance plan, with the objective of

guaranteeing savings to the state employees group benefits

self-insurance plan;

(2) recommendations on implementing the

primary care case management project to pay medicaid

fee-for-service providers a capitated rate for managing

patients' health status and treatment, and the healthy New

Mexico task force shall recommend the areas of the state

where this project can be implemented cost effectively;

(3) recommendations on requirements for

private health insurers and group health plans to reward

providers for controlling chronic diseases and chronic

conditions; and

(4) recommendations for funding and

implementing a pilot program to integrate prevention, early

intervention and case management in one targeted community

that the healthy New Mexico task force has identified as

being underserved as relating to health care services. The

pilot program shall focus especially, but not exclusively,

upon diabetes and obesity prevention, intervention and case

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management.

C. As used in this section:

(1) "chronic condition" or "chronic disease"

means a disease or condition that has a prolonged course,

that does not resolve spontaneously, involves functional

impairment or disability for which a complete cure is rarely

achieved and that may require ongoing medical care;

(2) "chronic condition management" or

"chronic disease management" means a system of coordinated

health care interventions and communications for individuals

with chronic diseases or chronic conditions, including

significant patient self-care efforts, system supports for

provider and patient relationships and a plan of care

emphasizing prevention of complications utilizing

evidence-based practice guidelines, patient empowerment

strategies and evaluation of clinical, humanistic and

economic outcomes on an ongoing basis with the goal of

improving overall health; and

(3) "disease management" means health care

services, including patient education, monitoring, data

collection and reporting, designed to improve health outcomes

in defined populations with selected chronic diseases.