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Senate | March 27, 2013 | Committee Room | Healthcare

Full MP3 Audio File

Thank you members of the committee, members of the public. To begin with today recognition of our pages beginning with Jaqueline Gr??, Senator Tucker, Reagan Booth, Senator Nesbitt, Maya Fin??, Senator Woodard, Timothy Jordan, Senator Brunstettar and Rebecca Cristo??, Senator Brown. [SPEAKER CHANGES] Thank you I hope you are having a wonderful week. [SPEAKER CHANGES] And our Sergeant at Arms for our senate committee today are Steve Wilson, I saw him here at the back, Ed Kessler, Kent Lewis and Billy Fritzer. [SPEAKER CHANGES] Thank you members. We have one bill on the committee today. Recognize Representative Tucker on Senate bill 208. Members of the committee there is a PCS. Do we have a motion? Senator Randleman moves for adoption of the PCS. All those in favor? Opposed? PCS is before us. [SPEAKER CHANGES] Thank you Senator Tucker. [SPEAKER CHANGES] Thank you Mr. Chairman. I appreciate you having us in on such short notice. This bill and the PCS is a long time coming. I have been working on this probably 4 weeks, is that about right folks? About 4 weeks and last week we were going to hear this bill and I got flooded by emails the night before so we pulled the bill and it's back up before you with some refinements to it. We had a meeting, Monday was a week ago I guess on this bill and it just simply outlines what the requirements are for the secretary of health and human services with regard to local management ?? and a managed care organizations contracted to operate under the 1915 VC waiver. We have probably 25 people in stakeholder meetings, providers, hospitals, the department, MCO's. A number of folks and we just came out of their with a general consensus on the bill their may be some amendment I need to run on the senate floor but this just clarifies the powers and duties and responsibilities of the Secretary of Health and Human Services. To move forward and to make a decision to if necessary absorb a failing MCO into one that is more successful so that services and provider payments will not be interrupted. That's the general gist of the bill. I would be glad to take any questions Mr. Chairman. [SPEAKER CHANGES] Any questions, members of the committee? Senator Hartsell. [SPEAKER CHANGES] Mr. Chairman, I'm not sure I have questions, just some comments and having just seen this and I've had some of these conversations with Senator Tucker but want to have some more based upon some information I received last night after seeing this. Actually to help strengthen this I think from another perspective. Without going into it in any great detail. A little more definition about fidelity to the PBH model because the wide variety of ways and ways that some folks have simply avoided doing that because they've tried to do that. A strengthening of the solvency issues, probably some greater definition of what a clean claim is and the reason I raise that Senator Tucker. And I haven't even thought about this until I got this comment. As we've talked about it's a managed care model and over time the way these are moving. They may move from not fee for service but for individual kind of performance or those kinds of just...then it becomes you have a change of what a clean claim is from a practical perspective so that it is helpful to try to take advantage of that as it evolves and there is some language that I think I can get you for that.

there may be a couple of others but I just wanted to raise that. I apologize, I got this last night, got some information out to some folks who deal with on a day to day basis with multiple MCOs’ [SPEAKER CHANGES] Mr. Chair, may I address that? [SPEAKER CHANGES] Absolutely. [SPEAKER CHANGES] Senator Hartsell I understand you mentioned fidelity to PBH model and the lack of some of the MCOs’ ability to adhere to that model which was supposed to be our blueprint to move forward in this I will be ameanable to some language that would allow that to happen. Also, I believe it was DHHS attorney that brought the fact that [clean claim] needed to have a better definition. There is a question still out there now about liability, who’s liable. So, I will probably have an amendment on the floor to address that. Ladies and Gentlemen, this is a very complicated Bill, everybody thought it was a Christmas tree. Let’s everything we can on to it, to possibly make it as stringent as possible, anything that is available to strengthen it I’ll be glad to take a look at it, I don’t know that I’ll do it or not, but I certainly be glad to take a look at it before and run an amendment on the floor. We need to move this out so we can get in to law, so the Secretary has all the opportunities she needs and the powers therewith to be able to operate the MCO in a manner which she can call the shots. This takes nothing away from her, some of the language is redundant to what’s in the contract, therefore we went ahead and included that, because we wanted to mirror what was in the contract and beyond that point. I would urge that and make a motion. I’m sorry Mr. Chair, sir you have a motion. [SPEAKER CHANGES] Moving for a favorable report of the PCS and not the original. [SPEAKER CHANGES] We have a motion for favorable report Committee Substitute, unfavorable to the original Bill. Any other questions or comments from the members of the Committee? I’m also going to open this up, before we do. Any comments from the Department, regarding the Bill or members of the public? Hearing none. Members of the Committee, all those in favor for the Bill signify by saying Aye, opposed No. The Ayes’ have it. Thank you. [SPEAKER CHANGES] Thank you Mr. Chairman. [SPEAKER CHANGES] Thank you members of the Committee, having exhausted the agenda we will stand adjourned.