HOUSE MEMORIAL 49

50th legislature - STATE OF NEW MEXICO - second session, 2012

INTRODUCED BY

Mimi Stewart

A MEMORIAL

REQUESTING THE NEW MEXICO LEGISLATIVE COUNCIL TO DIRECT THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE TO STUDY MEASURES TO REDUCE THE COST OF PROVIDING HEALTH CARE TO INCARCERATED OFFENDERS WHILE MAINTAINING QUALITY OF CARE.

     WHEREAS, as of June 30, 2011, the corrections department housed more than six thousand five hundred incarcerated offenders; and

     WHEREAS, incarcerated offenders frequently have serious medical conditions and include many women with high-risk pregnancies that require intensive medical care; and

     WHEREAS, according to corrections department data, approximately twenty-five percent of all inmates have a preexisting psychiatric illness and over eighty-five percent of all inmates have a substance abuse or substance dependence disorder; and

     WHEREAS, the corrections department has recently restructured its health services bureau to integrate and improve the quality of services; and

     WHEREAS, a goal of the department's strategic plan for 2011-2012 is to lower the cost of corrections; and

     WHEREAS, the detection of fraud, waste and abuse is critical to controlling health care costs; and

     WHEREAS, detection of fraud, waste and abuse can be accomplished through the analysis of automated health claims data; and

     WHEREAS, under certain circumstances, including inpatient admission to a hospital, nursing facility, juvenile psychiatric facility or intermediate care facility, federal law permits the corrections department to bill eligible health services provided to incarcerated offenders to the state's medicaid program; and

     WHEREAS, an automated claims processing system could be used to identify health care claims eligible for submission to the medicaid program; and

     WHEREAS, the corrections department contracts with various vendors and providers for health care and behavioral health services; and

     WHEREAS, a periodic review of the corrections department's health care and behavioral health services contracts should be undertaken to identify opportunities for potential cost savings and efficiency while maintaining quality of care;

     NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the New Mexico legislative council be requested to direct the legislative health and human services committee to work with the corrections department to develop recommendations for achieving cost savings while maintaining quality health care for incarcerated offenders; and

     BE IT FURTHER RESOLVED that the New Mexico legislative council be requested to direct the legislative health and human services committee to include in its considerations:

          A. use of state-of-the-art automated claims processing to prevent health care fraud, waste and abuse;

          B. adoption of an automated web-based system to screen and enroll each inmate at intake for medicaid eligibility and to track each inmate's medicaid eligibility status thereafter;

          C. use of state-of-the-art automated claims processing to identify health care claims that are medicaid- eligible;

          D. a review of existing corrections department contracts for health care and behavioral health services to identify potential areas of cost savings and efficiencies while maintaining quality of care; and

          E. integration of cost-saving measures related to health care and behavioral health services across the corrections department's correctional facilities; and 

     BE IT FURTHER RESOLVED that the New Mexico legislative council be requested to direct the legislative health and human services committee to issue its recommendations by November 1, 2012; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the chair and vice chair of the legislative health and human services committee, the secretary of corrections and the health services bureau of the corrections department.

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