HOUSE MEMORIAL 83

54th legislature - STATE OF NEW MEXICO - first session, 2019

INTRODUCED BY

Joanne J. Ferrary

A MEMORIAL

REQUESTING THE NEW MEXICO LEGISLATIVE COUNCIL TO CHARGE THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE WITH HOLDING HEARINGS DURING THE 2019 INTERIM THAT RELATE TO ACCESS TO CARE AND CENTENNIAL CARE 2.0 PROVIDER NETWORK ADEQUACY ISSUES.

     WHEREAS, more than nine hundred thousand New Mexicans receive their health care from New Mexico's medicaid program; and

     WHEREAS, the human services department projects a general fund need for funding medicaid of almost one billion dollars ($1,000,000,000); and

     WHEREAS, the combined total state and federal budget of the human services department is over seven billion dollars ($7,000,000,000); and

     WHEREAS, the delivery of timely medical care by the provision of adequate provider networks is of paramount importance; and

     WHEREAS, centennial care 2.0, enacted in the final months of the previous administration, reduced the number of managed care providers from four to three, potentially impacting timely access to critical medical care for the most needy; and

     WHEREAS, the upheaval imposed a serious burden on New Mexico families and individuals in need of medical, behavioral and long-term care; and

     WHEREAS, New Mexico currently has a shortage of doctors, nurses, psychiatrists and other medical professionals; and

     WHEREAS, New Mexico was ranked the forty-eighth lowest of the fifty states for access to health care by considering thirty-three factors, including physicians per one hundred thousand population and percentage of those with insurance, according to a recent report by a national physician recruiter; and

     WHEREAS, the human services department requires the three centennial care managed care organizations that serve medicaid members in New Mexico to provide adequate geographic access to primary care and other types of providers; and

     WHEREAS, those with low incomes on New Mexico's medicaid program are entitled to federally mandated health care access, including minimum medical appointment wait times; and

     WHEREAS, recent reports indicate that the largest managed care provider may have wait times for the most needy who receive care under the New Mexico medicaid program that are reported to be far longer than for other patients; and

     WHEREAS, a review of the currently configured centennial care 2.0 program is necessary to make significant changes where needed, including a re-procurement to address access to care;

     NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the New Mexico legislative council charge the legislative health and human services committee to conduct hearings during the 2019 interim relating to the extent to which beneficiaries in the centennial care 2.0 program are able to access needed medical services for their health care as determined by wait times for primary care provider appointments; specialist provider appointments for members with specific conditions such as high-risk pregnancies, diabetes, cancer, substance abuse disorder, behavioral health disorder or hepatitis C; and by the rate of utilization of medical procedures required to treat these conditions as recommended by the most current clinical research and the centennial care 2.0 program's own clinical criteria for these conditions; and

     BE IT FURTHER RESOLVED that the legislative health and human services committee conduct hearings related to the impact that medicaid managed care organizations in centennial care 2.0 have had on access to care for the program's beneficiaries and what actions have been taken to increase the breadth and depth of provider networks contracted to serve the program's beneficiaries and that a report detailing the hearings be made publicly available by the end of the 2019 interim; and

     BE IT FURTHER RESOLVED that, if necessary, the legislative health and human services committee request a commitment from the human services department to facilitate a re-procurement for centennial care 2.0 by December 31, 2019 to ensure that the program has adequate coverage from selected managed care organizations to raise the state's current national ranking on access to care for its beneficiaries and ensure these beneficiaries are receiving the high-quality health care deserved by all New Mexicans; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the governor, the co-chairs of the New Mexico legislative council and the chair and vice chair of the legislative health and human services committee.

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