Friday, August 10, 2007

Health Care Recommendations

The Health Coverage for New Mexicans Committee has submitted its recommendations to Governor Bill Richardson.
According to a news release from the Department of Human Services, the Committee’s key policy recommendations include:

1. Create a single statewide unified health care authority or governance structure based on the guiding principles adopted by the Committee that would be charged with implementing health care reforms regarding universal coverage, cost and quality controls and oversight of health care delivery in New Mexico.
2. Maximize enrollment in Medicaid and SCHIP as soon as economically feasible.
3. Reform New Mexico health insurance and HMO requirements to move towards guarantee issue for individuals regardless of health status or pre-existing condition; require a standard percent of premium collected by insurance companies to be spent on direct services; lower the twenty percent that insurance carriers can add to small group rates due to health status and claims experience and implement common data reporting.
4. Allow employers to buy into the state employee health risk pool and individuals without access to commercial insurance to buy into a Medicaid benefit plan.
5. Consolidate or create larger health insurance risk pools where beneficial and consolidate public administrative functions.
6. Require individuals to obtain coverage through public programs or commercial insurance.
7. Require employers to contribute in some way to coverage for employees.
8. Maximize health information technology such as enrollment, develop electronic medical records, diagnosis, billing claims, provider payment and reimbursement.
9. Increase provider recruitment and retention through incentives.
10. Consider a state-operated reinsurance or risk equalization program to distribute risk and manage the effects of catastrophic claims on any one pool due to medical procedures.

“Many recommendations may be implemented without delay following the successful passage of legislation in 2008,” the release said.

The committee’s final report is in the health care section at

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