Relates to accountable care organizations.
TITLE OF BILL: An act to amend chapter 461 of the laws of 2012, amending the public health law relating to accountable care organizations, in relation to a certain workgroup convened by the commissioner of health
PURPOSE: To adjust the charge and membership of the Accountable Care Organization (ACO) Workgroup in relation to Medicaid managed care, Family Health Plus and Child Health Plus.
SUMMARY OF PROVISIONS: Chapter 461 of 2012 created a workgroup to be convened by the Commissioner of Health to develop a proposal whereby an ACO could directly serve Medicaid, Family Health Plus or Child Health Plus enrollees. Prior to Governor Cuomo signing the bill, he and the Assembly and Senate leadership agreed to pass legislation to adjust that charge so the workgroup will consider whether such activity should be enabled, rather than directing it to develop such a proposal.
The agreement also called for adding representatives of health plans that serve those programs, as well as advocates for persons enrolled in those programs to the ACO workgroup.
This bill would enact the changes that were agreed to.
JUSTIFICATION: The workgroup will examine the feasibility of ACO direct contracts with public health programs, which in some cases would have the ACO acting in place of a managed care plan. The conclusions of the workgroup will advise the executive and legislature as to the advisability of such arrangements and what regulatory or statutory amendments would be required.
LEGISLATIVE HISTORY: New bill.
FISCAL IMPLICATIONS: None
EFFECTIVE DATE: Immediately, and deemed to be in full force and effect since October 3, 2012.
STATE OF NEW YORK ________________________________________________________________________ 2080 2013-2014 Regular Sessions IN SENATE January 10, 2013 ___________Introduced by Sen. HANNON -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend chapter 461 of the laws of 2012, amending the public health law relating to accountable care organizations, in relation to a certain workgroup convened by the commissioner of health THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 2 of chapter 461 of the laws of 2012, amending the public health law relating to accountable care organizations, is amended to read as follows: S 2. The commissioner of health shall convene a workgroup to
[develop a proposal whereby]CONSIDER WHETHER an ACO [may]SHOULD BE ENABLED TO serve, in place of a managed care plan: (a) Medicaid enrollees otherwise required to participate in managed care, care management, or care coor- dination under section 364-j of the social services law, section 4403-f of the public health law, or other law; and (b) enrollees in family health plus under section 369-ee or section 369-ff of the social services law and the child health insurance plan under title 1-A of article 25 of the public health law. The workgroup shall include, but not be limited to, representatives of: accountable care organizations or entities seeking to form an accountable care organization under article 29-E of the public health law; health care providers serving Medicaid enrollees; HEALTH PLANS THAT SERVE MEDICAID, FAMILY HEALTH PLUS AND CHILD HEALTH INSURANCE PLAN ENROLLEES, AND ORGANIZATIONS THAT ADVOCATE FOR Medicaid, family health plus, and child health insurance plan enrol- lees; and the senate and the assembly. The workgroup shall report its CONCLUSIONS AND recommendations, IF ANY, for regulatory or statutory actions to the governor [, the commissioner of health,]and the legisla- ture. S 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after October 3, 2012.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04594-01-3