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2017 Session

Budget Amendments - HB1500 (Member Request)

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Chief Patron: Knight
Report on CCC Plus Program Rates (language only)

Item 306 #27h

Item 306 #27h

Health and Human Resources
Department of Medical Assistance Services

Language

Page 311, after line 41, insert:

"WWWW. The Department of Medical Assistance Services (DMAS) shall neither submit for approval by the Centers for Medicare and Medicaid Services (CMS) nor execute any contracts for managed long-term services and supports, the Commonwealth Coordinated Care (CCC) Plus program, until the department completes a report of the rates developed for managed care contractors under the final terms of the proposed contract. The report shall include a determination of actuarial soundness as requires by 42 CFR 438.6(c). The department shall provide in the report details on its rate setting methodologies, processes and an overview of the data used in the rate development. DMAS shall provide this report and an analysis of future rates and funding requirements for the CCC Plus program to the Health Insurance Reform Commission for public review prior to executing contracts or submitting to CMS for approval. Further, the department shall present this report to the Chairmen of the Health Insurance Reform Commission, the House Appropriations Committee and Senate Finance Committee with at least ninety days notice before the effective data of any contract referenced herein."



Explanation

(This amendment adds language to require the agency to report, for the benefit of oversight by the Health Insurance Reform Commission and money committees, on the rates proposed under the CCC Plus program, to ensure that rates do not destabilize current services and the new services proposed to enrollees under the CCC Plus program and to ensure that funding is adequate to sustain the Medicaid program at current levels.)