Bill Text: MI SB0641 | 2021-2022 | 101st Legislature | Engrossed
Bill Title: Human services: medical services; sickle cell disease Medicaid managed care management collaboration act; create. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 106c.
Spectrum: Partisan Bill (Democrat 9-0)
Status: (Engrossed - Dead) 2022-09-28 - Referred To Committee On Health Policy [SB0641 Detail]
Download: Michigan-2021-SB0641-Engrossed.html
Substitute For
SENATE BILL NO. 641
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
(MCL 400.1 to 400.119b) by adding section 106c.
the people of the state of michigan enact:
Sec. 106c. (1) The department shall ensure the availability of accessible, quality health care for individuals with sickle cell disease or thalassemia and who are enrolled in Medicaid managed care organizations that have a contract with the department to provide services to Medicaid members in the comprehensive health care program.
(2) Not later than the fiscal year 2024 contract year, the department shall require comprehensive health care program Medicaid managed care organizations to implement a sickle cell disease quality strategy and a thalassemia quality strategy for children and adults with sickle cell disease or thalassemia that includes, but is not limited to, the following components:
(a) Measurable goals to improve the identification of members with sickle cell disease or thalassemia within 180 days after enrolling in the contracted health plan.
(b) Care coordination strategies and supports to help members with sickle cell disease or thalassemia access sickle cell disease or thalassemia specialists and other related care supports.
(c) A training curriculum to educate primary care providers on sickle cell disease and thalassemia, including information on emergency warning signs and complications, evidence-based practices and treatment guidelines, and when to make referrals to specialty sickle cell disease or thalassemia treatment providers.
(d) Performance measures relative to access to care and available therapies, engagement in treatment, and outcomes for individuals with sickle cell disease or thalassemia, with the metrics to be reported annually by the comprehensive health care program Medicaid managed care organizations and with incentive payments attached to the measures.
(3) The department shall also do the following:
(a) Leverage the state sickle cell disease surveillance system to provide an annual report to the senate and house appropriations committees and the senate and house fiscal agencies, that includes identifying gaps and quality in services, access to care trends, uptake of disease modifying therapies, health outcomes, insurance enrollment figures of children and adults, and disparities. The department must publish this report on the department's website.
(b) Not later than January 1, 2025, and in partnership with the comprehensive health care program Medicaid managed care organizations, identify, document, and share best practices regarding sickle cell disease care management and care coordination and thalassemia care management and care coordination with Medicaid-enrolled primary care and sickle cell disease or thalassemia specialty providers with a goal of improving services for members with sickle cell disease or thalassemia and their families.
(d) Not later than January 1, 2025, develop a plan for improving the transition from pediatric care to adult care and a plan for helping qualified beneficiaries maintain Medicaid coverage under another eligibility category, in order to maintain continuity of care.
(4) Not later than January 1, 2024, the department must develop guidelines to incorporate sickle cell disease performance standards and measures and thalassemia performance standards and measures into contracts for the contract year 2025. The guidelines must include a mechanism to incentivize plans to meet the included standards and measures. The department must publicly report the included standards and performance measures annually.
