The bill aims to amend the Medicaid Provider-Led Organized Care Act to enhance the enrollment and selection process for risk-based provider organizations, while also empowering Medicaid beneficiaries with essential information. Key provisions include the establishment of a quality rating system for risk-based provider organizations, which will be accessible online and include various performance metrics such as care coordinator caseload ratios, satisfaction survey scores, and follow-up care percentages. Additionally, the bill mandates that provider directories be updated in real-time and that beneficiaries have access to a dedicated support system through the Department of Human Services.

Furthermore, the legislation outlines the responsibilities of the Department of Human Services in maintaining a beneficiary support office that will assist enrollees with information regarding provider networks, open enrollment, and the quality rating system. The ombudsman will also be empowered to help resolve issues between enrollees and provider organizations. The act is set to take effect on January 1, 2026, and allows the Department of Human Services to promulgate rules for its implementation.