Senate Bill No. 483-Committee on Human Resources and Facilities
June 26, 1997
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Referred to Committee on Finance
SUMMARY--Requires Legislative Committee on Health Care to evaluate expanding access to health care in this state. (BDR S-1802)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State or on Industrial Insurance: Contains Appropriation not included in Executive Budget.
EXPLANATION - Matter in italics is new; matter in brackets [ ] is material to be omitted.
AN ACT relating to health care; requiring the Legislative Committee on Health Care to conduct a study to evaluate expanding access to health care in this state; requiring the committee to make recommendations for establishing a mandatory Medicaid managed care program to the Interim Finance Committee; requiring the Department of Human Resources to seek certain approvals and waivers from the Federal Government; making an appropriation; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1 1. The Legislative Committee on Health Care shall conduct a study to evaluate expanding access to health care in this state. The study must evaluate:
(a) Expanding eligibility for Medicaid to other medically needy persons in this state, including, without limitation, medically needy children, women, persons with disabilities and working adults.
(b) Expanding services provided to recipients of Medicaid.
(c) The long-term and catastrophic health care needs of all persons in this state.
(d) Incentives that may be provided to employers to encourage them to provide health care insurance for their employees.
(e) The responsibility that corporations should accept over the provision of health care services to their employees.
(f) Establishing an independent office to advocate on behalf of consumers of health care.
(g) Identifying all potential sources of funding for the provision of health care services to all persons in this state, including, without limitation, private and public sources of funding.
(h) Establishing a mandatory Medicaid managed care program for all recipients of Medicaid. Any such program must include, without limitation:
(1) Access to quality health care services;
(2) Coverage of health care services in at least the same amount, scope and duration as are provided to recipients of Medicaid as of July 1, 1997;
(3) Protections for recipients of Medicaid, including, without limitation, adequate procedures for filing complaints and appeals regarding the provision of health care services; and
(4) Access to adequate outpatient services and other alternatives to care provided in a hospital.
2. In addition to other providers of health care, any mandatory Medicaid managed care program established must contract with providers of health care who provide services at no charge or for a fee for services based upon a sliding scale that is determined based on the income of a patient, who do not restrict access or services because of the financial limitations of a patient, and who:
(a) Historically have served medically needy or medically indigent patients and have demonstrated a commitment to serve such patients by dedicating a significant portion of their business to such patients; or
(b) Are the only providers of health care in their communities and to the best of their ability have served the medically indigent patients in their communities.
3. Any provider of health care who contracts to provide services to recipients of Medicaid through any Medicaid managed care program established must agree to presume that certain persons are eligible for Medicaid, including, without limitation, certain pregnant women and persons with physical disabilities.
4. The Legislative Committee on Health Care shall establish the:
(a) Manner in which any necessary waivers must be obtained from the Federal Government;
(b) Manner of carrying out the purposes of the Medicaid managed care program;
(c) Procedures for protecting recipients of Medicaid from fraud;
(d) Method of enrolling persons in the Medicaid managed care program;
(e) Procedures for guaranteeing that recipients of Medicaid have adequate due process protections;
(f) Manner for determining the scope of services provided by the Medicaid managed care program; and
(g) Manner of collecting data concerning the Medicaid managed care program.
5. The Legislative Committee on Health Care shall:
(a) Report its recommendations to the governor and the department of human resources on or before July 1, 1998; and
(b) Submit quarterly reports to the interim finance committee concerning the progress of its study and its recommendations for establishing a mandatory Medicaid managed care program.
Sec. 2 The Department of Human Resources shall, with the consent of the Interim Finance Committee:
1. Seek all necessary approvals and waivers from the Federal Government to accomplish the goals identified in the recommendations submitted by the Legislative Committee on Health Care pursuant to subsection 3 of section 1 of this act; and
2. Submit quarterly reports concerning its progress in obtaining such approvals and waivers to the Legislative Committee on Health Care.
Sec. 3 1. There is hereby appropriated from the state general fund to the Legislative Committee on Health Care the sum of $200,000 for hiring a consultant to assist the committee in conducting its study and making recommendations pursuant to section 1 of this act.
2. Any remaining balance of the appropriation made by subsection 1 must not be committed for expenditure after July 1, 1998, and reverts to the state general fund as soon as all payments of money committed have been made.
Sec. 4 This act becomes effective on July 1, 1997.