Bill > S396

This bill amends the existing law to require Senior Care Options (SCOs) to evaluate all their enrollees within 90 days of initial enrollment, and annually thereafter, to determine if they have complex care needs. If an enrollee is determined to have complex care needs, they may receive the ongoing services of 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 their ongoing services, the enrollee will still receive care from a primary care physician and can appeal the decision. The bill also requires SCOs to develop and obtain approval from the Division of Medical Assistance for the criteria they will use to determine if a complex care enrollee requires the ongoing services of a primary care team.

Health and Social Services

https://malegislature.gov/Bills/192/S396