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Tuesday the Human Services Committee heard HB-5297, An Act Concerning Statewide Expansion of the Primary Care Case Management Pilot Program. The bill would, as the title says, expand PCCM statewide as of October 1st and delay the planned evaluation of the program until next year. Advocates have raised concerns about DSS’ plans to evaluate the program prematurely, worried that it could incorrectly label the program a “failure” and serve as an excuse to shut it down. PCCM has only 322 members; legislation requires at least 1,000. DSS plans to hire Mercer for the evaluation; Mercer receives much of its revenue from HMOs.
At the hearing, legislators peppered the commissioner with questions about why DSS has not been supportive of PCCM especially marketing restrictions such as requiring providers to print their own brochures or restricting providers from talking to their patients about PCCM but allowed to answer questions if asked. Legislators noted that they have heard very positive feedback from PCCM providers and were concerned that physicians in parts of the state beyond DSS’ current four towns who want to join the program (a remarkable and wonderful thing) are being told that they can’t participate. Legislators were particularly interested in what happened to $5 million appropriated in the last two years to support PCCM. DSS answered that they used the money to cover their deficit, which includes the $50 million overpayments to the HMOs uncovered by the Comptroller’s audit.
Ellen Andrews