S.F. No. 3279 Summary

• Provides all eligible medical assistance enrollees the opportunity to opt out of managed care enrollment in experimental counties, with the commissioner developing criteria for when choice limitations may be implemented.

• Establishes an enrollee support system that must provide counseling on choosing a managed care plan or opting out, assist with understanding enrollment, handle complaints, and help navigate grievance and appeals processes.

• Allows the commissioner to enroll persons with disabilities in managed care plans under Medicare special needs plans, unless the individual chooses to opt out, with enrollment and opt-out procedures established by the commissioner.

• Expands the definition of "enrollment broker" to include individuals or entities performing choice counseling or enrollment activities in accordance with federal regulations, to assist enrollees in selecting managed care organizations.

• Applies the opt-out provision to county-based purchasing of health care services, requiring counties to honor enrollees' choices to opt out of the prepaid medical assistance program.

• All amendments are effective January 1, 2023.