Senate Bill 838 Summary

• Department of Health and Human Services must submit a report by October 1, 2016, detailing the status of the 1115 waiver submission to CMS, a detailed work plan for Medicaid transformation implementation with key milestones and assigned responsibilities, and any developments or changes during planning that could affect implementation.

• Modifies Medicaid transformation timelines requiring DHHS to submit waivers and State Plan amendments to CMS by June 1, 2016, with capitated contracts to begin 18 months after CMS approval of all necessary waivers and amendments.

• Increases the maximum number of regional managed care contracts from 10 to 12 and excludes behavioral health services for Medicaid recipients from capitated contracts for four years after contracts begin.

• Expands excluded populations and services from capitated contracts, including dual-eligible beneficiaries, certain immigrant populations, medically needy recipients, tribal members, and services provided through schools, early intervention providers, and the Program of All-Inclusive Care for the Elderly (PACE).

• Authorizes DHHS to seek CMS approval through the 1115 waiver to allow parents to retain Medicaid eligibility while their child is temporarily in foster care and clarifies that DHHS can maintain program components within its budget without reductions unless OSBM certifies insufficient recurring Medicaid funds exist.