HJ 577

Abstract

Study; joint subcommittee; oversight of Medicaid managed care organizations and provider networks in the Commonwealth; report. Establishes a joint subcommittee to study oversight of Medicaid managed care organizations and provider networks in the Commonwealth, including (i) the current process by which the Department of Medical Assistance Services enters into contracts with managed care organizations for the delivery of services to Medicaid enrollees and the requirements of such contracts; (ii) the process by which managed care organizations enter into and terminate contracts with providers in the Commonwealth, including any procedural requirements that must be met before a provider agreement is terminated and any opportunity for communication and correction by the provider; (iii) managed care organizations' provider networks, including demographic information about enrolled providers and recent changes in managed care organizations' provider networks, including demographic information about providers that have been added to or removed from provider networks in recent years; and (iv) whether changes should be made to contracts between the Department of Medical Assistance Services and managed care organizations to ensure providers are able to meet agreements set forth in provider agreements while ensuring the safety and well-being of Medicaid enrollees, and to develop recommendations for improving the process by which providers of Medicaid services are recruited, enrolled in, participate in, and are terminated from provider networks to ensure access to a diverse array of services and providers for all Medicaid enrollees in the Commonwealth. The joint subcommittee shall complete its meetings by November 30, 2021, and the chairman shall submit to the Division of Legislative Automated Systems an executive summary of its findings and recommendations no later than the first day of the 2022 Regular Session of the General Assembly.