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| SPONSOR: | Knauer | DATE TYPED: | 02/02/99 | HB | 137 | ||
| SHORT TITLE: | DD Medicaid Waiver Eligibility | SB | |||||
| ANALYST: | Burris | ||||||
| Recurring
or Non-Rec |
Fund
Affected | ||||
| FY99 | FY2000 | FY99 | FY2000 | ||
| NFI | |||||
(Parenthesis ( ) Indicate Expenditure Decreases)
Duplicates/Conflicts with/Companion to/Relates to
SOURCES OF INFORMATION
LFC Files
Department of Health
Developmental Disabilities Planning Council
Governor's Committee on Concerns of the Handicapped
Human Services Department
New Mexico Health Policy Commission
SUMMARY
Synopsis of Bill
House Bill 137 amends NMSA 1978, Section 27-2-12.6 to exclude the following services from the Medicaid managed care program: intermediate care facilities for the mentally retarded (ICF/MR), developmental disability (DD) early intervention, DD early intervention case management services, and DD services for children and adults funded from state general fund.
Significant Issues
NMSA 1978, Section 27-2-12 allows the Human Services Department (Department) to exclude the above listed programs from managed care, however, it is not required. Currently the Department has not excluded these programs from managed care.
FISCAL IMPLICATIONS
House Bill 137 will allow consumers of the affected services more input and choice in the services they receive. However, it is likely that returning to the fee-for-service model will increase the cost of providing them as capitated payments are more cost-effective.
CONFLICT
House Bill 137 conflicts with SB 157, which also amends NMSA 1978, Section 27-2-12.
OTHER SUBSTANTIVE ISSUES
The Human Services Department reports that it has been working on a managed long-term care initiative that will allow pooling of funds to leverage health care dollars. The Medical Assistance Division is piloting a Pre-PACE (program of all-inclusive care for the elderly) in Bernalillo County that pools Medicaid, Medicare, private insurance and private payments to develop a comprehensive long.-term care system. House Bill 137 will limit this and future efforts to create innovative funding programs for DD patients.
RLB/njw:gm