Department of Medical Assistance Services; Medicaid estate recoveries. Directs the Department of Medical Assistance Services (the Department) to limit the operation of its estate recovery program to the recovery of only federally required costs. The bill directs the Department to make information on estate recovery available on its website in multiple languages. The bill directs the Department to adopt emergency regulations to implement the provisions of the bill.
Department of Medical Assistance Services; enhanced oversight of services facilitators. Directs the Department of Medical Assistance Services to enhance oversight of Medicaid services facilitation for consumer directed services, including incorporation of such services into the statewide Fiscal Employer Agent contract and development of a contract monitoring and oversight plan.
Firefighters Cancer Screening Grant Program and Fund established. Creates the Firefighters Cancer Screening Grant Program and Fund to award grants to localities for costs incurred in providing certain cancer detection tests to firefighters. The bill provides that in any year that the amount of funds in the Firefighters Cancer Screening Fund reduces to zero and the Fund does not receive a separate appropriation, the Grant Program and Fund shall expire.
Administrative Process Act; exemptions; limitations; appeals of case decisions regarding benefits sought. Specifies that the Administrative Process Act applies to case decisions regarding the grant or denial, including determinations of eligibility and approved levels of service, of Temporary Assistance for Needy Families, Medicaid, Supplemental Nutrition Assistance Program benefits, general relief, auxiliary grants, or state-local hospitalization. The bill also removes provisions limiting review of case decisions to ascertaining whether there was evidence in the agency record to support the case decision of the agency.
Health insurance; treatment of cancer and certain diseases; coverage of certain medications. Requires an insurer, corporation providing preferred provider subscription contracts, or health maintenance organization that provides coverage for drugs approved by the Food and Drug Administration and prescribed for the treatment of cancer or diseases of the blood to allow, at the patient's direction, (i) provider-administered drugs for such treatment to be dispensed by an in-network treating provider consistent with a provider agreement; (ii) provider-administered drugs for such treatment to be dispensed by an in-network treating provider when there is a documented delay of at least three days in the delivery of a medication from the designated specialty pharmacy; and (iii) self-administered drugs for such treatment to be sent to the pharmacy of the patient's choosing.
Use of artificial intelligence system by mental health service providers; civil penalty. Permits the use of an artificial intelligence system by mental health service providers to assist in providing therapy or counseling services if such mental health service provider maintains full responsibility for all interactions, outputs, and data use associated with the system. The bill prohibits the use of an artificial intelligence system to provide therapy or counseling services without a mental health service provider. The bill specifies that records kept by mental health service providers must comply with health records privacy requirements; creates an exception for religious counseling, peer support, or self-help materials and educational resources; and establishes a civil penalty not to exceed $10,000 for violations of the statute.
Fees for vehicles designed and used for transportation of passengers; funds returned to a locality; permitted uses. Expands the permitted use of funds returned to a locality from certain vehicle fees to include the purchase or maintenance of necessary equipment, supplies, facilities, and vehicles permitted by the Office of Emergency Medical Services and other operating expenses deemed necessary by the locality to ensure the provision of emergency medical services in such locality by nonprofit emergency medical services agencies. Under current law, such funds may be used for the purchase of necessary equipment and supplies for use in the locality for emergency medical services provided by nonprofit emergency medical services agencies.
Nursing homes; periodic medical visits and resident assessments. Requires all nursing homes to notify the resident of a nursing home, the resident's family, and the Department of Health if a federally required physician visit does not take place. The bill also requires each nursing home to conduct a comprehensive assessment on an annual basis to determine each resident's needs and describe each resident's capability to perform daily life functions. Such assessments must be reviewed at least once every 92 days, and more frequently in the event of a significant change in the resident's physical or mental condition.
Health carriers; use of artificial intelligence; disclosures. Requires health carriers to disclose to the State Corporation Commission's Bureau of Insurance how artificial intelligence is used to manage claims coverage and to submit all information enabling decisions made by artificial intelligence to the Bureau upon request. The bill also requires health carriers to provide notice to enrollees and health care providers when artificial intelligence has been used to issue an adverse determination and to provide a clear and timely process for appeal of such determination.
Maternal Health Monitoring Pilot Program established; report. Directs the Department of Health to implement the Maternal Health Monitoring Pilot Program that provides for remote patient monitoring for maternal hypertension and maternal diabetes. The bill requires the Department to select a managed care organization and technology vendor to administer the Pilot Program and to submit a report to the Governor and General Assembly no later than 18 months after the first eligible participant is enrolled in the Pilot Program.