0001|                           SENATE BILL 315
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0002|     43RD LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION, 1998
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0003|                            INTRODUCED BY
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0004|                            LINDA M. LOPEZ
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0005|     
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0006|                                   
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0007|                                   
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0008|             FOR THE HEALTH AND WELFARE REFORM COMMITTEE
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0009|                                   
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0010|                                AN ACT
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0011|     RELATING TO PUBLIC ASSISTANCE; EXCLUDING COMMUNITY-BASED
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0012|     DEVELOPMENTAL DISABILITY PROGRAMS FROM THE MEDICAID MANAGED
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0013|     CARE PROGRAM; AMENDING A SECTION OF THE PUBLIC ASSISTANCE ACT;
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0014|     MAKING AN APPROPRIATION.
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0015|     
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0016|     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
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0017|          Section 1.  Section 27-2-12.6 NMSA 1978 (being Laws 1994,
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0018|     Chapter 62, Section 22) is amended to read:
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0019|          "27-2-12.6.  MEDICAID PAYMENTS--MANAGED CARE.--
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0020|               A.  |Except as provided in Subsection D of this
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0021|     section|, the department shall provide for a statewide,
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0022|     managed care system to provide cost-efficient, preventive,
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0023|     primary and acute care for medicaid recipients by July 1,
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0024|     1995.
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0025|               B.  The managed care system shall ensure:
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                                        - 1 -

0001|                    (1)  access to medically necessary services,
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0002|     particularly for medicaid recipients with chronic health
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0003|     problems; 
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0004|                    (2)  to the extent practicable, maintenance of
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0005|     the rural primary care delivery infrastructure;
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0006|                    (3)  that the department's approach is
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0007|     consistent with national and state health care reform
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0008|     principles; and
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0009|                    (4)  to the maximum extent possible, that
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0010|     medicaid-eligible individuals are not identified as such
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0011|     except as necessary for billing purposes. 
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0012|               C.  The department may |from the provisions of this
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0013|     section| exclude nursing homes, ~[intermediate care facilities
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0014|     for the mentally retarded,]~ medicaid in-home and
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0015|     community-based waiver services and residential and
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0016|     community-based mental health services for children with
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0017|     serious emotional disorders ~[from the provisions of this
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0018|     section]~.
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0019|               |D.  The department shall exclude from the
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0020|     provisions of this section intermediate care facilities for
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0021|     the mentally retarded, developmental disability in-home and
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0022|     community-based medicaid waiver services, developmental
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0023|     disability early intervention services, development disability
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0024|     early intervention case management services and development
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0025|     disability state general fund services for children and
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                                        - 2 -

0001|     adults.|"
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0002|          Section 2.  APPROPRIATION.--Twenty-five thousand dollars
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0003|     ($25,000) is appropriated from the general fund to the human
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0004|     services department for expenditure in fiscal year 1999 for
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0005|     the purpose of contracting with a statewide developmental
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0006|     disabilities community provider association located in
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0007|     Bernalillo county to conduct and complete, prior to the 1999
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0008|     legislative session, an assessment of community-based
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0009|     developmental disability managed care programs operated in
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0010|     other states.  Any unexpended or unencumbered balance
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0011|     remaining at the end of fiscal year 1999 shall revert to the
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0012|     general fund.
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0013|                              
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