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Legislation watch
2019 Senate Bill 5523: Improving managed care organization performance in caring for medicaid clients
Introduced by Sen. John Braun (Centralia) (R) on January 23, 2019
Referred to the Senate Health & Long-Term Care Committee on January 23, 2019
Referred to the Senate Ways & Means Committee on January 31, 2019
Referred to the Senate Rules Committee on February 27, 2019
Amendment offered by Sen. John Braun (Centralia) (R) on March 13, 2019
Requires Managed Care Organizations (MCOs) to be measured based on 7 total performance measures, as opposed to under four general categories.
(2) Requires MCOs to be measured based on 3 common measures across all MCOs, and 4 quality focus performance measures specific to that individual MCO.
(3) Adjusts the total withhold for each MCO from 4 percent, to 3 percent.
(4) Adjusts how an MCO may earn back the withhold: Instead of performing at or above the national average, or making statistically significant improvements on performance, an MCO must either make statistically significant improvement or score in the top quartile of the performance measure.
(5) Permits HCA to use an alternative methodology to approximate top quartile performance for up to 2 of the 4 quality focus performance measures.
The amendment passed by voice vote in the Senate on March 13, 2019
Received in the House on March 15, 2019
Referred to the House Appropriations Committee on March 15, 2019