Medical assistance program design.

2016
STATE OF WYOMING
16LSO-0401
Introduced
1.2

SENATE FILE

NO.

SF0086

Medical assistance program design.

Sponsored by:
Senator(s) Scott and Nicholas, P. and Representative(s) Brown and Harvey

A BILL

for

AN ACT relating to medical assistance; requiring the development of a design for a medical assistance program for people who cannot afford adequate health care; providing principles for the design as specified; requiring the management council to designate an entity to develop the design; requiring input from stakeholders; prohibiting the submission of a request for medicaid expansion to the federal government as specified; providing an appropriation; and providing for an effective date.

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

Section 1.

(a)

The Wyoming legislature's management council shall direct the design of a program providing medical assistance
to
people who cannot afford adequate health care.

(b)

The
program
design shall follow
these princip
l
e
s:

(i)

The design shall seek to maximize improvements in the health status of program participants given reasonably available medical and other resources and shall seek to
provide greater
health status
improvements
than
those provided by
the medicaid program;

(ii)

The design, in conjunction with other assistance programs, shall seek to create a pathway for participants to leave governmental assistance and become self-sufficient;

(iii)

The design shall be coordinated with other assistance programs so that participants always have an incentive to improve their earnings and economic status.
To achieve this end, the design may include recommended changes to other government assistance programs;

(iv)

The
design shall include a work requirement for participants who are able to work;

(v)

The design shall
allow
participation by participants, if any, who are unable to work and who are not eligible for health care assistance from other program
s
, including programs
associated with supplementa
l security
income (SSI);

(vi)

The
design shall include incentives and other mechanisms for participants and health care providers to avoid unnecessary health care costs and to reduce the cost
s
of health care;

(vii)

The design shall consider the use of health savings accounts or similar accounts to provide incentives for appropriate cost and utilization reduction;

(viii)

The design shall consider and recommend changes in the current medicaid program which would
improve
health
outcomes for current medicaid clients and reduce medicaid cost
as a means of financing or helping to finance
the medical assistance prog
ram designed under this section;

(ix)

The design shall seek to avoid spending monies that Wyoming does not have and shall seek to avoid the creation of any uncontrolled entitlement that may grow beyond the resources Wyoming can reasonably expect to have in the future;

(x)

The design shall comply with the requirements of the Wyoming
C
onstitution, Article 16, Section 6, concerning the necessary support of the poor;

(xi)

The design shall seek to facilitate the movement of participants from the medicaid program and the medical assistance program designed under this section to private insurance including employer provided insurance and privately purchased insurance;

(xii)

The design shall consider
housing
the new medical assistance program
in the department of family services, the Wyoming
health insurance pool
or any other state agen
cy and may consider moving the m
edicaid program to the same entity;

(xiii)

The design shall consider financing the medical assistance program from savings
created by operation of the program
in the existing medicaid program, savings in other health and welfare p
r
ograms and from the financing mechanisms available to the
Wyoming health insurance pool
;

(xiv)

The development of the design shall not be unreasonably constrained by current federal health policies and requirements;

(xv)

The design may be implemented through an expansion of
Wyoming's participation in the
medicaid program with appropriate federal waivers or changes, as part of any available medicaid block grant or as a free-standing state program.

Section 2.

(a)

The management council may assign the developme
n
t of the design
required by section 1 of this act
to a joint interim committee, a special or select legislative committee or to a joint task force with public and executive branch members.

(b)

The management council shall set appropriate time schedules and deadlines for the design effort which shall include a report before the 2017 general session
and before the 2018 budget session.

Section 3.

(a)

The entity develo
ping the design required by

section 1 of this act
shall:

(i)

At its initial meeting or at an early meeting, seek information, advice and recommendations from the general public and
other stakeholders
;

(ii)

Receive assistance, advice and information from the department of family services, the department of insurance and
Wyoming health insurance pool
, the department of workforce services and the department of health;

(iii)

Request advic
e and recommendations from the governor.

(b)

The state of Wyoming shall not seek approval from the federal government
for
an expansion of
its participation in
the medicaid program
until
the design of the medical assistance program has been submitted to and considered by the legislature.

(c
)

The management council may authorize the use of consultants or temporary or part-time employees to assist in staffing and performing the functions required by this act.

(d
)

There is appropriated from the general fund to the legislative service office twenty thousand dollars
($20,000.00) for the purpose of performing the tasks required in this act. This appropriation shall be expended only for the purposes authorized by this act. These funds shall not be transferred or expended for any other purpose and any unexpended, unobligated funds remainin
g from this appropriation on June 30, 2019 shall revert
as provided by
law.

Section 4.

This act is effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

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SF0086