HOUSE BILL NO. 4496 A bill to amend 1939 PA 280, entitled "The social welfare act," by amending sections 105b and 109f (MCL 400.105b and 400.109f), section 105b as added by 2007 PA 100 and section 109f as amended by 2017 PA 224; and to repeal acts and parts of acts. the people of the state of michigan enact: Sec. 105b. (1) The department of community health shall work with contracted health plans to create incentives for individual medical assistance recipients who practice specified positive health behaviors. The incentives described in this subsection may include, but are not limited to, expanded benefits and incentives relating to premiums, co-pays, or benefits. The positive health behaviors described in this subsection may include, but are not limited to, participation in health risk assessments and health screenings, compliance with medical treatment, attendance at scheduled medical appointments, participation in smoking cessation treatment, exercise, prenatal visits, immunizations, and attendance at recommended educational health programs. (2) The department of community health shall create pay-for-performance incentives for contracted medicaid Medicaid health maintenance organizations. The medicaid Medicaid health maintenance organization contracts shall may include incentives for meeting health outcome targets for chronic disease states, increasing the number of medical assistance recipients who practice positive health behaviors, and meeting patient compliance targets established by the department. of community health. Priority shall may be given to strategies that prevent and manage the 10 most prevalent and costly ailments affecting medical assistance recipients. (3) The department of community health shall establish a preferred product and service formulary program for durable medical equipment. The department of community health shall work with the centers for medicare and medicaid services Centers for Medicare and Medicaid to determine if a joint partnership with medicare Medicare is possible in establishing the program described in this subsection as a means of achieving savings and efficiencies for both the medicaid and medicare Medicaid and Medicare programs. The preferred product and service formulary program for durable medical equipment shall require participation from the department of community health and shall permit the contracted medicaid Medicaid health maintenance organizations and provider organizations to participate. (4) The department of community health shall seek financial support for electronic health records, including, but not limited to, personal health records, e-prescribing, web-based medical records, and other health information technology initiatives using medicaid Medicaid funds. (5) The department of community health shall include in any federal waiver request that is submitted with the intent to secure federal matching funds to cover the medically uninsured nonmedicaid population in the state language to allow the department of community health to establish, at a minimum, the programs required under subsections (1) and (2). (5) (6) The department of community health shall not implement incentives under this section that conflict with federal statute or regulation. Sec. 109f. (1) The department shall support the use of Medicaid funds for specialty services and supports for eligible Medicaid beneficiaries with a serious mental illness, developmental disability, serious emotional disturbance, or substance use disorder. Medicaid-covered specialty services and supports shall be managed and delivered by specialty prepaid health plans chosen by the department. The Except for beneficiaries who are eligible for dual enrollment in Medicare and Medicaid, the specialty services and supports shall be carved out from the basic Medicaid health care benefits package. (2) Specialty prepaid health plans are Medicaid managed care organizations as described in section 1903(m)(1)(A) of title XIX, 42 USC 1396b, and are responsible for providing defined inpatient services, outpatient hospital services, physician services, other specified Medicaid state plan services, and additional services approved by the Centers for Medicare and Medicaid Services under section 1915(b)(3) of title XIX, 42 USC 1396n. (3) This section does not apply to a pilot project authorized under section 298(3) of article X of 2017 PA 107. Enacting section 1. Sections 105c, 105f, 107a, and 107b of the social welfare act, 1939 PA 280, MCL 400.105c, 400.105f, 400.107a, and 400.107b, are repealed.
HOUSE BILL NO. 4496
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
by amending sections 105b and 109f (MCL 400.105b and 400.109f), section 105b as added by 2007 PA 100 and section 109f as amended by 2017 PA 224; and to repeal acts and parts of acts.
the people of the state of michigan enact:
Sec. 105b. (1) The department of community health shall work with contracted health plans to create incentives for individual medical assistance recipients who practice specified positive health behaviors. The incentives described in this subsection may include, but are not limited to, expanded benefits and incentives relating to premiums, co-pays, or benefits. The positive health behaviors described in this subsection may include, but are not limited to, participation in health risk assessments and health screenings, compliance with medical treatment, attendance at scheduled medical appointments, participation in smoking cessation treatment, exercise, prenatal visits, immunizations, and attendance at recommended educational health programs.
(2) The department of community health shall create pay-for-performance incentives for contracted medicaid Medicaid health maintenance organizations. The medicaid Medicaid health maintenance organization contracts shall may include incentives for meeting health outcome targets for chronic disease states, increasing the number of medical assistance recipients who practice positive health behaviors, and meeting patient compliance targets established by the department. of community health. Priority shall may be given to strategies that prevent and manage the 10 most prevalent and costly ailments affecting medical assistance recipients.
(3) The department of community health shall establish a preferred product and service formulary program for durable medical equipment. The department of community health shall work with the centers for medicare and medicaid services Centers for Medicare and Medicaid to determine if a joint partnership with medicare Medicare is possible in establishing the program described in this subsection as a means of achieving savings and efficiencies for both the medicaid and medicare Medicaid and Medicare programs. The preferred product and service formulary program for durable medical equipment shall require participation from the department of community health and shall permit the contracted medicaid Medicaid health maintenance organizations and provider organizations to participate.
(4) The department of community health shall seek financial support for electronic health records, including, but not limited to, personal health records, e-prescribing, web-based medical records, and other health information technology initiatives using medicaid Medicaid funds.
(5) The department of community health shall include in any federal waiver request that is submitted with the intent to secure federal matching funds to cover the medically uninsured nonmedicaid population in the state language to allow the department of community health to establish, at a minimum, the programs required under subsections (1) and (2).
(5) (6) The department of community health shall not implement incentives under this section that conflict with federal statute or regulation.
Sec. 109f. (1) The department shall support the use of Medicaid funds for specialty services and supports for eligible Medicaid beneficiaries with a serious mental illness, developmental disability, serious emotional disturbance, or substance use disorder. Medicaid-covered specialty services and supports shall be managed and delivered by specialty prepaid health plans chosen by the department. The Except for beneficiaries who are eligible for dual enrollment in Medicare and Medicaid, the specialty services and supports shall be carved out from the basic Medicaid health care benefits package.
(2) Specialty prepaid health plans are Medicaid managed care organizations as described in section 1903(m)(1)(A) of title XIX, 42 USC 1396b, and are responsible for providing defined inpatient services, outpatient hospital services, physician services, other specified Medicaid state plan services, and additional services approved by the Centers for Medicare and Medicaid Services under section 1915(b)(3) of title XIX, 42 USC 1396n.
(3) This section does not apply to a pilot project authorized under section 298(3) of article X of 2017 PA 107.
Enacting section 1. Sections 105c, 105f, 107a, and 107b of the social welfare act, 1939 PA 280, MCL 400.105c, 400.105f, 400.107a, and 400.107b, are repealed.