Medicaid; accountable care organizations. (SB5007)

Introduced By

Sen. Bill Stanley (R-Moneta)

Description

Medicaid; accountable care organizations. Directs the Department of Medical Assistance Services (Department) to establish a health care delivery system under which a majority of the Commonwealth's Medicaid beneficiaries will receive benefits through accountable care organizations (ACOs). ACOs are corporations that provide health care services through their member health care providers and receive Medicaid payments through innovative payment methodologies, which include capitated payments, gainsharing payment arrangements, pay-for-performance, quality-based payments, and other payment arrangements to generate savings from greater coordination and efficiency in service delivery. A portion of these cost savings are to be distributed among the health care providers participating in the ACO. Prior to contracting with the Department, a proposed ACO shall obtain a certification of authority issued by the State Corporation Commission (Commission), which can be issued if the ACO satisfies requirements regarding working capital and reserves. The Commission and the Attorney General are further required to determine (i) whether a proposed ACO is likely to reduce competition in a market for health care services and (ii) that the ACO's pro-competitive benefits are likely to substantially outweigh the anticompetitive effects of any increase in market power. The Department is directed to apply for federal waivers required for implementation of the program. Read the Bill »

Status

09/18/2014: Awaiting a Vote in the Commerce and Labor Committee

History