Tuesday, May 13, 2008

Governor Perdue Signs CMO Reform Bill

Today Governor Sonny Perdue visited Putnam General Hospital in Eatonton to sign House Bill 1234, a comprehensive reform of the way the Department of Community Health contracts with Care Management Organizations (CMOs) and to provide benefits for members of Georgia’s Peachcare for Kids and Medicaid programs.

“The two primary goals of shifting to managed care were to reduce the unsustainable slope of increasing healthcare costs for Peachcare and Medicaid and to encourage healthy lifestyles among those covered by these two programs,” said Governor Sonny Perdue. “I believe we have achieved both of those goals, and the reforms in this bill will continue to improve the delivery of these services.”

In 2006, the State awarded contracts to three CMOs for the delivery of services through the Peachcare for Kids and Medicaid programs. The three CMOs are Amerigroup Community Care, Peach State Health Plan and WellCare. HB 1234 includes numerous provisions to improve the delivery of services to plan members and the relationship between the CMOs and Georgia’s health care providers.

“Governor Perdue took the bold step of transitioning nearly 1 million Medicaid recipients to managed care through care management organizations in an effort to control costs and improve healthcare outcomes. HB 1234 is an attempt to refine and improve this effort,” said Rep. Mickey Channell, sponsor of the legislation. “The legislation streamlines the management of costs and healthcare outcomes, stabilizes procedures and processes, and increases transparency so that the standards by which care is either provided or denied are known to providers and patients. Healthcare providers, Medicaid patients, and the State of Georgia should benefit from this bill.”

Senator Johnny Grant and Senator Greg Goggans also attended today’s bill signing ceremony, and Governor Perdue thanked them for their efforts in passing the bill in the Senate.

Among the provisions in the bill are requiring CMOs to post contracted-providers names on a website so that members can make informed choices about their physicians of choice. The legislation also addresses the dental network and streamlines the appeals process for providers who submit claims to CMOs.

For more information on the bill, go to www.legis.state.ga.us.

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