NOTE: As provided in LFC policy, this report is intended for use by the standing finance committees of the legislature.  The Legislative Finance Committee does not assume responsibility for the accuracy of the information in this report when used in any other situation.

The LFC is only preparing FIRs on bills referred to the Senate Finance Committee, the Senate Ways and Means Committee, the House Appropriations and Finance Committee and the House Taxation and Revenue Committee. The chief clerks are responsible for preparing and issuing all other bill analyses.

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(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates/Conflicts with/Companion to/Relates to

SOURCES OF INFORMATION

New Mexico Health Policy Commission

  -No information received from the Department of Health or the Human Services Department

SUMMARY

Synopsis of Amendment

The Senate Corporations and Transportation Committee amendments do the following:

    1. Removes from the title of Section 3, the phrase, "Consultation and"

    2. Removes language on page 2 that required the department to take the Legislative Finance Committee's recommendations into consideration when making decisions regarding the contractual process.

    3. Changes the words, "consult with' , to now read, "advise" on page 2, line 13.

    4. Changes language on page 2, line 21, to require only the "general content" of the responses to the requests for proposals.

    5. Inserts a new subsection on page 3, between lines 5 and 6 to now read, "Nothing in this section shall be interpreted as giving the committee any authority concerning the determination of the content of the request for proposals or the selection of successful bidders."

    6. On page 3, line 24 removes the words, "and profits" to remove the requirement to include that data as part of the necessary information to be submitted to the department and the Legislative Finance Committee.

The House Consumer and Public Affairs Committee amendments do the following:

1. On page 3, line 11, strike "Each" and insert in lieu thereof "For each".

2. On page 3, line 12, after "department" insert ", the department".

3. On page 3, line 12, after "report" insert "to the committee".

4. On page 4, line 12, after "specifications" insert "and compliance with the Patient Protection Act".

All of these amendments clarify intent and are not considered substantive changes to the proposed legislation.

Synopsis of Bill

House Bill 641 requires the Legislative Finance Committee to annually review the operations, management and impact of the medicaid managed care program and report its findings and recommendations to the legislature. The bill requires by January 1 of the year preceding the fiscal year in which a contract for the provision of medicaid managed care is expected to be signed, responses to the requests for proposals including cost information, shall be made available to the committee prior to the signing of the contracts for services. The bill further requires that by October 1, of each year that further information be supplied to the committee for their use in determining the impact of the medicaid managed care program. Additional sections of the proposed legislation require information needed to analyze contract renewals, the efficiency and effectiveness, trends in enrollment, and other factors to determine the propriety of the medicaid managed care program and it's contract provisions.

Significant Issues

The legislature and it's interim committees have been left without information necessary for them to determine the effectiveness of the medicaid managed care program. Appropriation of the monies necessary to operate this large program without proper information is not good legislative practice and is not in the long term interests of their constituents, whose taxes pay for this program. There have been numerous requests of legislators to determine if this program is effective and is responsive to the needs of it's clients. To date, the legislature has not received all the information it feels is necessary to make informed decisions on these appropriations. Certainly there is serious concern on the enrollment of children into the program and the lack of response by the executive branch on the urgent need to enroll these clients.

FISCAL IMPLICATIONS

The fiscal implications of the medicaid managed care program are substantial. Enrollment of all individuals who are entitled to the benefits of this program will cost more money. The legislature has the responsibility of providing the necessary resources to finance this program but must have the necessary information to make these decisions in a timely manner.

ADMINISTRATIVE IMPLICATIONS

Administration of the provisions of this proposed legislation will require significant amounts of legislative finance committee staff time and effort. The resources necessary to administer these provisions are within the budgeted capacity of the LFC.

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