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2014 SPECIAL SESSION I

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SB 5006 Medicaid; regional care organizations.

Introduced by: William M. Stanley, Jr. | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Medicaid; regional care organizations. Directs the Department of Medical Assistance Services (Department), subject to approval of the federal Centers for Medicare and Medicaid Services, to enter into contracts in regions of the Commonwealth with a regional care organization (RCO). Under the contracts, an RCO will provide medical care to Medicaid beneficiaries and receive capitated payments from the Department. The Department is required to enroll a majority of the Commonwealth's Medicaid beneficiaries into RCOs. An RCO may contract with any willing health care provider to provide services in a Medicaid region if the provider is willing to accept the payments and terms offered to comparable providers. In order to be certified as an RCO, an organization is required to be certified by the Department as meeting eligibility requirements, including financial standards and service delivery network requirements.


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