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Moore’s bill could improve care for seriously disabled |
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August 2, 2005 - A bill to provide specialized services designed to meet the particular care needs of seriously disabled individuals under the age of 65 received legislative approval this week and was sent to Governor Romney for his signature. The legislation, co-sponsored by Senator Richard T. Moore (D-Uxbridge) and House Majority Whip Lida Harkins (D-Needham), would, if signed by the governor and approved by federal officials, establish a new managed care program for disabled individuals who qualify for both Medicare and Medicaid. The program, aimed at helping disabled people with the most serious health needs and high financial need, is modeled on a successful program that serves the elderly known as the Senior Care Options or “SCO” program. Senator Moore was the leading sponsor of the SCO program that now serves over 2100 senior citizens in the state. “The primary purpose,” Senator Moore explained, “is to provide coordinated, high-quality care and services to enable individuals to remain in their homes or in a community setting rather than in a nursing home or other institution. It’s better quality of life for those being served, and more cost-effective for the taxpayers,” he added. The Harkins-Moore Bill would give the state Secretary of Health and Human Services (EOHHS) the authority to certify the financial solvency of any Massachusetts-based “care delivery organization” applying to the federal Centers for Medicare and Medicaid Services (CMS) to become a Medicare Advantage Special Needs Plan (SNP). According to Timothy Murphy, Secretary of EOHHS, the agency does not currently have the authority to certify agencies serving an under-65 population. CMS created the SNP program to allow care delivery organizations to coordinate specialized Medicaid and Medicare services to various high-need populations. Because many of the organizations that deliver these specialized services are small and because they will be at financial risk for delivering all needed services within the program capitation revenue, CMS requires applicant organizations to be certified by a state agency as financially solvent. The state’s Executive Office of Health and Human Services currently certifies the financial solvency of senior care organizations providing the similar services for those over age 65. |
