Bill Text: IN HB1277 | 2010 | Regular Session | Introduced
Bill Title: Reporting requirements on health information.
Spectrum: Bipartisan Bill
Status: (Enrolled - Dead) 2010-03-01 - Senate advisor appointed: Becker and Breaux [HB1277 Detail]
Download: Indiana-2010-HB1277-Introduced.html
Citations Affected: IC 2-5-26-16; IC 5-22-9-2.5; IC 12-15.
Synopsis: Health disparities in Medicaid. Requires a managed care
organization (MCO) that contracts with the office of Medicaid policy
and planning (OMPP) to provide Medicaid services to do the
following: (1) Report to the select joint commission on Medicaid
oversight concerning the MCO's culturally and linguistically
appropriate services standards plan and the progress in implementing
these standards. (2) Report to OMPP specified member related
information. (3) Implement standards concerning culturally and
linguistically appropriate services (CLAS), and encourage practices
that are more culturally and linguistically accessible. (4) Develop and
administer a community based health disparities advisory council. (5)
Include as part of the member's pharmacy benefits that the labeling of
the prescription drug be printed in the member's preferred language.
Requires OMPP to, beginning January 1, 2011, withhold a percentage
of reimbursement from a managed care organization under specified
circumstances. Requires the inclusion of criteria evaluating the MCO's
cultural competency in working with minority populations in a request
for proposal, and requires preferences to be awarded to an MCO that
shows evidence of cultural competency. Requires OMPP to: (1)
annually report certain Medicaid claims information to the legislative
council; and (2) establish standards and guidelines and ensure
continuity of care for Medicaid recipients who transfer from an MCO.
Requires Medicaid vendors to establish specified quality initiatives.
Effective: July 1, 2010.
January 12, 2010, read first time and referred to Committee on Public Health.
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A BILL FOR AN ACT to amend the Indiana Code concerning
human services.
(1) The managed care organization's culturally and linguistically appropriate services (CLAS) standards plan, including the managed care organization's progress in implementing the standards.
(2) The progress of a contractor of the managed care organization in implementing a culturally and linguistically appropriate services standards plan.
Medicaid policy and planning concerning managed care
organizations providing services for the risk-based managed care
Medicaid program under IC 12-15, the office of Medicaid policy
and planning shall:
(1) include as criteria that will be used in evaluating the
proposal information concerning the managed care
organization's cultural competency in working with minority
populations in Indiana; and
(2) award preferences to a managed care organization that
provides evidence of cultural competency in working with
minority populations.
(1) The number and demographic characteristics of the individuals receiving Medicaid during the preceding fiscal year.
(2) The number of births during the preceding fiscal year.
(3) The number of infant deaths during the preceding fiscal year.
(4) The improvement in the number of low birth weight babies for the preceding fiscal year.
(5) The total cost of providing Medicaid during the preceding fiscal year.
(6) The total cost savings during the preceding fiscal year that are realized in other state funded programs because of providing Medicaid.
(7) The number of all claims concerning the following:
(A) Emergency room visits.
(B) Hospitalizations.
(C) Birth delivery outcomes by race and age, including the following:
(i) The number of vaginal deliveries.
(ii) The number of cesarean deliveries.
(iii) The number of vaginal birth after cesarean (VBAC) deliveries.
(iv) The average birth weight.
(v) The average gestational age.
(vi) The number of babies placed in neonatal intensive care units.
(vii) The average length of hospital stay of a baby.
(D) Pharmacy services.
(E) Professional services provided to a pregnant woman,
including the following:
(i) Doctor visits.
(ii) Dental visits.
(iii) Any other professional care provided, including care
for human immunodeficiency virus (HIV).
(F) Immunizations.
(8) The number of Medicaid recipients who transfer from a
managed care organization to a different managed care
organization under the Medicaid program, including the
following:
(A) The number of Medicaid recipients transferring out of
each managed care organization.
(B) The number of Medicaid recipients transferring into
each managed care organization.
(C) The following information regarding the transferring
recipient:
(i) Race.
(ii) Reason for transfer.
(iii) The health outcomes for each recipient during the
six (6) months after the recipient transfers.
The report must be in an electronic format under IC 5-14-6.
(1) Report to the office all member related information with information concerning the:
(A) race; and
(B) primary language;
of the member.
(2) Implement standards concerning culturally and linguistically appropriate services (CLAS) as required by
federal law to encourage practices that are more culturally
and linguistically accessible, including:
(A) establishing and administering a written plan; and
(B) reporting annually on the progress of the plan.
(3) Develop and administer a community based health
disparities advisory council as described in subsection (c).
(4) Include as part of the member's pharmacy benefits that
the labeling of the prescription drug be printed in the
member's preferred language.
(b) The managed care organization shall:
(1) provide the culturally and linguistically appropriate
services (CLAS) standards report required by subsection (a)
to the interagency state council on black and minority health
established by IC 16-46-6-3; and
(2) make the report available to the public upon request.
(c) The community based health disparities advisory council
developed by each managed care organization as required in
subsection (a)(3) must include the following:
(1) At least two (2) members who are minority (as defined in
IC 16-46-6-2) Medicaid recipients.
(2) Seventy-five percent (75%) of the members must be
individuals who are not employed by the managed care
organization, representing the following:
(A) Health care professionals.
(B) Advocates in the health and human services area.
(C) Individuals who provide direct services to risk-based
managed care recipients.
(3) At least one (1) member representing each of the
following:
(A) The Indiana Minority Health Coalition.
(B) The commission on Hispanic/Latino affairs established
by IC 4-23-28-2.
(C) American Indian Center of Indiana.
(D) Asian Help Services.
(E) The Arc of Indiana.
(F) The Central Indiana Council on Aging.
(G) An entity that provides direct services to risk-based
managed care recipients.
The council membership must reflect the population served.
(d) A community based health disparities advisory council shall
do the following:
(1) Provide input and assist the managed care organization in
the development and implementation of the culturally and
linguistically appropriate services (CLAS) standards.
(2) Review the annual assessment and evaluate whether the
plan is improving minority health outcomes.
(3) Review the final report required by subsection (a)(1).
(4) Approve stipend reimbursement for travel expenses,
including mileage for council members who reside in a city
other than where the council meeting is being held to travel to
attend a council meeting.
(e) A managed care organization shall pay for the costs of the
managed care organization's community based health disparities
advisory council.
(f) Beginning January 1, 2011, the office shall withhold a
percentage of reimbursement from a managed care organization
based on a lack of progress by the managed care organization in
improving health disparity outcomes.
(1) Prepare requirements, including qualifications, for bidders offering to contract with the state to perform the functions under section 3 of this chapter.
(2) Assist the Indiana department of administration in preparing bid specifications in conformity with requirements.
(b) The office shall comply with the requirements of IC 5-22-9-2.5 in preparing a bid for managed care organization services under the risk-based managed care program.
(1) contracts with the office to provide direct services, including pharmacy vendors; and
(2) receives reimbursement under Medicaid;
shall implement at least two (2) quality improvement initiatives to reduce health disparities, at least one (1) of which addresses race, ethnic, or other geographic disparities.
(b) The initiatives required in subsection (a) must do the following:
(1) Include baseline data on individuals who receive services from the contractor.
(2) Include measurable goals and outcomes.
(3) Use a third party source to evaluate the contractor's
initiatives.
(4) Be in one (1) of the following categories:
(A) Obstetrics.
(B) Asthma.
(C) Diabetes.
(D) Immunizations.
(E) Healthcare effectiveness data and information set.
