CS/HB 727 - Medicaid Managed Care Summary

• Authorizes the Agency for Health Care Administration to extend or modify contracts with behavioral health care providers through October 1, 2014, to ensure continuity of care

• Removes the October 1, 2014 expiration date on the agency's authority to impose fines on contracted entities (up to $2,500 per nonwillful violation, $20,000 per knowing/willful violation)

• Allows the agency to calculate medical loss ratios for managed care plans if required by federal waiver, with specific criteria for classifying expenditures including graduate medical education funding and state trust fund contributions

• Specifies that Medicaid program administration contracts are not rules and are not subject to the Administrative Procedure Act

• Includes Medicare Advantage plans in the definition of comprehensive long-term care plans and eligible plans for managed medical assistance; requires managed care plans to inform enrollees about selecting a primary care provider and establish appointment scheduling procedures

• Modifies the preference criteria for plan selection to use a tiered approach for in-state operations rather than an absolute preference; adds Medicare plans to long-term care program eligibility with procurement exemptions for dually eligible beneficiaries

• Takes effect July 1, 2012