Bill > S349

This bill amends the General Laws to require Senior Care Organizations (SCOs) to evaluate all their enrollees to determine if they have complex care needs within 90 days of initial enrollment and on an annual basis thereafter. If an enrollee is determined to have complex care needs, they may receive ongoing services from a primary care team, which will develop and monitor a care plan for the enrollee. If the primary care team determines the enrollee does not require primary care team services, the enrollee can appeal that decision to the SCO. The SCO is required to develop criteria for the primary care team to use in determining whether the enrollee requires ongoing primary care team services, and submit those criteria to the Division of Medical Assistance for approval.

Health and Social Services

https://malegislature.gov/Bills/191/S349