Bill Text: HI SCR153 | 2012 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Department of Human Services; Demonstration Project; Healthcare Integration; Medicaid and Medicare

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed - Dead) 2012-04-16 - (H) Referred to HUS/HLT, FIN, referral sheet 66 [SCR153 Detail]

Download: Hawaii-2012-SCR153-Amended.html

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THE SENATE	S.C.R. NO.	153
TWENTY-SIXTH LEGISLATURE, 2012		S.D. 1
STATE OF HAWAII

SENATE CONCURRENT

RESOLUTION

 

 

REQUESTING THE DEPARTMENT OF HUMAN SERVICES TO IMPLEMENT A DEMONSTRATION PROJECT TO INTEGRATE HEALTHCARE FOR INDIVIDUALS ENROLLED IN BOTH MEDICAID AND MEDICARE.

 

 

     WHEREAS, Medicaid and Medicare enrollees are a particularly vulnerable population; and

 

     WHEREAS, Medicaid and Medicare enrollees have high healthcare expenditures, receive fragmented care, have multiple healthcare related identification cards, and may be unsure of who to call for help; and

 

     WHEREAS, providers who serve Medicaid and Medicare recipients must submit both Medicaid and Medicare claims and navigate two separate prior authorization, coverage, and other administrative processes; and

 

     WHEREAS, the Centers for Medicare and Medicaid Services has proffered the opportunity for demonstrations to integrate primary, acute, behavioral health, and long-term care services; and

 

     WHEREAS, the Department of Human Services already has Centers for Medicare and Medicaid Services-approved QUEST Expanded Access Medicaid managed care health plans that include Centers-approved dual eligible special needs plans; and

 

     WHEREAS, future QUEST Expanded Access health plans with dual eligible special needs plans would be expected to join the integration demonstration; now, therefore,

 

     BE IT RESOLVED by the Senate of the Twenty-sixth Legislature of the State of Hawaii, Regular Session of 2012, the House of Representatives concurring, that the Department of Human Services is requested to implement a demonstration project to integrate care for individuals enrolled in both Medicaid and Medicare in order to improve patient-centeredness and quality of care, help reduce provider administrative burden, and generate savings to the state and federal governments; and

 

     BE IT FURTHER RESOLVED that the Department of Human Services is requested to optimize participation in the integration demonstration project while preserving consumer choice; and

 

     BE IT FURTHER RESOLVED that the Department of Human Services mitigate the impact of the integration demonstration project on competing Centers for Medicare and Medicaid Services-approved dual eligible special needs plans that are not also a QUEST Expanded Access Medicaid managed care health plan by ensuring solely traditional Medicare members will be enrolled in the integration demonstration project; and

 

     BE IT FURTHER RESOLVED that the Department of Human Services is requested to ensure that the project takes place in conjunction with the anticipated re-procurement of the QUEST Expanded Access contract; and

 

     BE IT FURTHER RESOLVED that the Director of Human Services is requested to submit an informative report to the Legislature on the Department's implementation plan for the integration demonstration project no later than twenty days prior to the convening of the Regular Session of 2013 detailing its plan and Memorandum of Agreement with the Centers for Medicare and Medicaid Services, including but not limited to:

 

     (1)  Public notice and meaningful consumer and other stakeholder engagement;

 

     (2)  Enrollment targets and related outreach initiatives;

 

     (3)  Integrated care management across primary, acute, behavioral health, and long-term care services and supports;

 

     (4)  Certifiable estimates of expected savings from the Office of the Actuary in the Centers for Medicare and Medicaid Services;

 

     (5)  Integrated beneficiary level claims data for program management and evaluation;

 

     (6)  Adequate access to networks of medical and support services providers;

 

     (7)  Monitoring and oversight infrastructure;

 

     (8)  Quality measurement infrastructure;

 

     (9)  Implementation timeline; and

 

    (10)  Proposed legislation, if any; and

 

     BE IT FURTHER RESOLVED that the Department of Human Services is also requested to submit a subsequent detailed report of findings, challenges, and recommendations, including proposed legislation, if any, no later than twenty days prior to the convening of the Regular Session of 2014; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Governor, Director of Health, and Director of Human Services.

Report Title: 

Department of Human Services; Demonstration Project; Healthcare Integration; Medicaid and Medicare