Sunday, January 9, 2011

Recent State Bills Introduced

Several pieces of legislation introduced in Maryland request that telemedicine be used to provide medical care in underserved areas. Michael D. Smigiel from Maryland pre filed HB 14 on November 17, 2010 and will introduce the bill in the Maryland legislature on January 12, 2011. HB 14 would require health insurance carriers to reimburse a licensed healthcare provider for a covered service provided using telemedicine technology in medically underserved areas.

Another bill HB 16 also introduced by Smigiel would require a task force to study the use of telemedicine also in medically underserved areas and report their findings to the Governor by September 30, 2012

The task force would study the impact of the changing physician supply and demographics on the distribution of healthcare services in the state, complete a cost-benefit analysis of the use of telemedicine in the medically underserved populations, study the continued use of telemedicine, the impact of telemedicine on non-health related issues such as the impact on the environment, and instituting a unified credentialing system for physicians, physician assistants, and nurse practitioners.

In New Jersey, SB 2443 was introduced on December 6, 2010 to establish a Medicaid Accountable Care Organization (ACO) Demonstration Project in the Department of Human Services. Participants in the demonstration project would be non-profit corporations and be established where only 5,000 Medicaid recipient live.

The bill introduced by State Senator Joseph F. Vitale would require general hospitals, clinics, health centers, qualified primary care and behavioral healthcare providers, public health and social services to apply to Medicaid for certification and participation in the project.

The plan is for the ACO model to improve quality and access increase primary care, provide behavioral healthcare and dental care, reduce unnecessary and inefficient care, plus provide a model that can be replicated in other settings to benefit patients and payers throughout New Jersey.

One major goal of the legislation is to reduce the inappropriate use of high cost emergency care by Medicaid recipients and others. Providers can continue to receive Medicaid fee-for-service payments and other types of Medicaid reimbursement directly from the Medicaid program while participating in a certified Medicaid ACO.

In New Mexico, State Senator Dede Feldman introduced HB 35 to establish an ACO Demonstration Project Task Force to study the feasibility for an ACO demonstration project. The ACO project would help Medicaid recipients, the State Children’s Health Insurance Program, and the State Coverage Insurance Program recipients in Hidalgo County.

The Task Force will need to work with representatives from the state human services department, the New Mexico Health Policy Commission, the University of New Mexico Health Sciences Center, managed care contractors, a nonprofit primary care organization and others to develop a two –year strategic plan on how to implement the project. The Task Force would then need to report their findings to the health and human services and finance committees by August 1, 2010.

The plan is to discuss the feasibility for implementing a financial model, the risks for a regional or community-based ACO in Hidalgo County, the role of managed care contractors, and how to effectively provide care along with case management.