SPONSOR: Helms
This bill requires the Department of Social Services to develop and oversee a pilot program in Greene and Christian counties that allows MO HealthNet participants to receive health care services through direct primary care arrangements. A direct primary care arrangement allows a physician to charge a monthly fee that covers all or most primary care services. The pilot program will run from January 1, 2021 to December 31, 2026. The department must send a report to the General Assembly annually on the pilot program.
Each enrollee in the program shall be enrolled in a direct primary care provider plan. The direct primary care plan shall include the following restrictions:
(1) The monthly enrollment fee shall not exceed a weighted average of $70 per month;
(2) The managed care provider shall designate participating direct primary care providers as the manager for enrollees, with some limitations; and
(3) The managed care provider shall not be liable for increased costs resulting from implementation of the pilot program.
The department must pursue all necessary waivers from the federal government to implement the provisions of this pilot program and if it is unable to obtain the waivers, the department must implement the program to the degree possible without the waivers.
This bill is the same as HB 233 (2019) and HB 1588 (2018).
Statutes affected: