Medicaid diversion program.

WORKING DRAFT
2011
STATE OF
WYOMING
11LSO-0523

SENATE FILE
NO.
SF0133

Medicaid diversion program.

Sponsored by:
Senator(s) Scott and Schiffer and Representative(s) Bonner, Brown and Harvey

A BILL

for

AN ACT relating to
the Medicaid program; providing for diversion of some Medicaid recipients and qualified applicants to the healthy frontiers or similar program; providing enrollment criteria; authorizing receipt of and continuously appropriating funds;
and providing for an effective date.

Be It Enacted by the Legislature of the State of
Wyoming
:

Section 1.

W.S. 42
‑
4
‑
301 through 42
‑
4
‑
30
5
are created to read:

ARTICLE 3
MEDICAID DIVERSION PROGRAM

42
‑
4
‑
301.

Medicaid diversion program created.

The Medicaid diversion program is created to reduce Medicaid expenditures by diverting adult
recipients

and qualified applicants
from the Medicaid program to the healthy frontiers health care reform demonstration project pursuant to W.S. 26
‑
43
‑
201 through 26
‑
43
‑
207 or a similar program limited to individuals diverted from Medicaid.

42
‑
4
‑
302.

Diversion; department of health duties.

(a)

The
department of health may divert
from
the
Medicaid

program
adult recipients
or qualified applicants
, subject to the following:

(i)

The
person diverted

voluntarily consents to the diversion;

(ii)

At the time of the diversion, the
person diverted is a current recipient

or qualified applicant for
the Wyoming
Medicaid program;

(iii)

The
person diverted
shall comply with work requirements of the healthy frontiers program within one hundred twenty (120) days of enrollment in the Medicaid diversion program;

(iv)

The
person diverted

meets
all other eligibility requirements of W.S. 26
‑
43
‑
204;

(v)

The
cumulative
number of recipients or qualified applicants diverted shall not exceed five hundred (500) prior to January 1, 2012, one thousand (1,000) prior to April 1, 2012 and two thousand (2,000) thereafter;

(vi)

The
person diverted shall pay premiums and contributions to the personal health account on the same sliding scale as other participants in the healthy frontiers project;

(vii)

The director of the department of health may at any time discontinue further diversions and may, with one hundred twenty (120)
days
notice to
persons diverted pursuant to this article, disenroll all persons in the program and may transfer qualified recipients back to the Medicaid program.

42
‑
4
‑
303.

Receipt and use of funds
.

The director of the department of
health
may accept federal or private funds, or both, to pay for any part of the expenses of the diversion program, provided that no conditions attached to the receipt of the funds jeopardize the integrity of the diversion program. The state expenses for the program shall be paid from the health care financing line item appropriation in the department of health budget and from premiums paid by the persons diverted. Premiums and other funds received as authorized by this section are continuously appropriated to the department for purposes of the diversion program.

42
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4
‑
304.

Medicaid diversion program; evaluation and reports.

(a)

The director of the department of health shall report to the joint appropriations interim committee and the joint labor, health and social services interim committee by November 15, 2012 and December 31, 2014
on:

(i)

The number of persons enrolled in the diversion program;

(ii)

P
er client expenditures
in the program
,
itemizing
total and state general fund
expenditures
;

(iii)

A comparison of per client expenditures in the diversion program to per client expenditures for comparable persons in the Medicaid program.

42
‑
4
‑
305
.

Sunset.

This article is
repealed effective December 31, 2015 and all participants shall be disenrolled effective July 1, 2015
.

Section 2.

This act is effective July 1, 2011.

(END)

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SF0133