A.4673 Schimminger
S.3296 Rath

An act to amend to social services law, in relation to mandatory managed care for certain recipients of medical assistance.

Synopsis:
In current statute, certain populations are exempt from enrolling in a managed care program and they receive flexible and comprehensive services under Medicaid’s fee for service program, due to the unique and intensive nature of their needs. These populations are: individuals eligible for Medicare and enrolled in a program of the Tax Equity and Fiscal Responsibility Act, individuals receiving SSI, individuals who are HIV positive, and individuals with serious mental illness. 

Status:
This bill was committed to the Senate Rules Committee on 6/21/07 and the Senate Social Services Committee on 1/9/08.  The bill was referred to the Assembly Health Committee on 1/9/08.

Summary of Provisions:

• This bill seeks to amend the definition of “managed care provider” to include rural health networks and agencies which hold “comprehensive HIV special needs plan certificate authority.”
• This bill revises current social services law to require the previously excluded Medicaid beneficiaries to enroll in a managed care program.  These groups are: individuals eligible for Medicare and enrolled in a program of the Tax Equity and Fiscal Responsibility Act, individuals receiving SSI, individuals who are HIV positive, and individuals with serious mental illness.
• The Commissioner of Health must gain federal approval and financial support to require enrollment from these individuals.

NASW-NYS Position:
NASW-NYS opposes this proposed legislation and has issued a Memorandum in Opposition.