* § 364-jj. Special advisory review panel on Medicaid managed care.
(a) There is hereby established a special advisory review panel on
Medicaid managed care. The panel shall consist of sixteen members who
shall be appointed as follows: six by the governor, one of which shall
serve as the chair; four each by the temporary president of the senate
and the speaker of the assembly; and one each by the minority leader of
the senate and the minority leader of the assembly. At least three
members of such panel shall be members of the joint advisory panel
established under section 13.40 of the mental hygiene law. The panel
shall include a consumer representative for individuals with behavioral
health needs, a consumer representative for individuals who are dually
eligible for medicare and Medicaid, a representative of entities that
provide or arrange for the provision of services to individuals with
behavioral health needs, and a representative of entities that provide
or arrange for the provision of services to individuals who are dually
eligible for medicare and Medicaid. Members shall serve without
compensation but shall be reimbursed for appropriate expenses. The
department shall provide technical assistance and access to data as is
required for the panel to effectuate the mission and purposes
established herein.

(b) The panel shall:

(i) determine whether there is sufficient managed care provider
participation in the Medicaid managed care program;

(ii) determine whether managed care providers meet proper enrollment
targets that permit as many Medicaid recipients as possible to make
their own health plan decisions, thus minimizing the number of automatic
assignments;

(iii) review the phase-in schedule for enrollment, of managed care
providers under both the voluntary and mandatory programs;

(iv) assess the impact of managed care provider marketing and
enrollment strategies, and the public education campaign conducted in
New York city, on enrollees participation in Medicaid managed care
plans;

(v) evaluate the adequacy of managed care provider capacity by
reviewing established capacity measurements and monitoring actual access
to plan practitioners;

(vi) examine the cost implications of populations excluded and
exempted from Medicaid managed care;

(vii) evaluate the adequacy and appropriateness of program materials;

(viii) examine trends in service denials;

(ix) assess the access to care for people with disabilities;

(x) in accordance with the recommendations of the joint advisory
council established pursuant to section 13.40 of the mental hygiene law,
advise the commissioners of health and developmental disabilities with
respect to the oversight of DISCOs and of health maintenance
organizations and managed long term care plans providing services
authorized, funded, approved or certified by the office for people with
developmental disabilities, and review all managed care options provided
to persons with developmental disabilities, including: the adequacy of
support for habilitation services; the record of compliance with
requirements for person-centered planning, person-centered services and
community integration; the adequacy of rates paid to providers in
accordance with the provisions of paragraph 1 of subdivision four of
section forty-four hundred three of the public health law, paragraph
(a-2) of subdivision eight of section forty-four hundred three of the
public health law or paragraph (a-2) of subdivision twelve of section
forty-four hundred three-f of the public health law; and the quality of
life, health, safety and community integration of persons with
developmental disabilities enrolled in managed care; and

(xi) examine other issues as it deems appropriate.

(c) Commencing January first, nineteen hundred ninety-seven and
quarterly thereafter the panel shall submit a report regarding the
status of Medicaid managed care in the state and provide recommendations
if it deems appropriate to the governor, the temporary president and the
minority leader of the senate, and the speaker and the minority leader
of the assembly.

* NB Effective until December 31, 2025

* § 364-jj. Special advisory review panel on Medicaid managed care.
(a) There is hereby established a special advisory review panel on
Medicaid managed care. The panel shall consist of nine members who shall
be appointed as follows: three by the governor, one of which shall serve
as the chair; two each by the temporary president of the senate and the
speaker of the assembly; and one each by the minority leader of the
senate and the minority leader of the assembly. All members shall be
appointed no later than September first, nineteen hundred ninety-six.
Members shall serve without compensation but shall be reimbursed for
appropriate expenses. The department shall provide technical assistance
and access to data as is required for the panel to effectuate the
mission and purposes established herein.

(b) The panel shall:

(i) determine whether there is sufficient managed care provider
participation in the Medicaid managed care program;

(ii) determine whether managed care providers meet proper enrollment
targets that permit as many Medicaid recipients as possible to make
their own health plan decisions, thus minimizing the number of automatic
assignments;

(iii) review the phase-in schedule for enrollment, of managed care
providers under both the voluntary and mandatory programs;

(iv) assess the impact of managed care provider marketing and
enrollment strategies, and the public education campaign conducted in
New York city, on enrollees participation in Medicaid managed care
plans;

(v) evaluate the adequacy of managed care provider capacity by
reviewing established capacity measurements and monitoring actual access
to plan practitioners;

(vi) examine the cost implications of populations excluded and
exempted from Medicaid managed care; and

(vii) examine other issues as it deems appropriate.

(c) Commencing January first, nineteen hundred ninety-seven and
quarterly thereafter the panel shall submit a report regarding the
status of Medicaid managed care in the state and provide recommendations
if it deems appropriate to the governor, the temporary president and the
minority leader of the senate, and the speaker and the minority leader
of the assembly.

* NB Effective December 31, 2025