Current through Pa Acts 2024-53, 2024-56 through 2024-92
Section 7003 - Patient-centered medical home advisory council(a) Establishment.--The Patient-Centered Medical Home Advisory Council is established. The council shall advise the department on how Pennsylvania's Medicaid program can increase the quality of care while containing costs through the following Patient-Centered Medical Home model approaches: (1) Coordinate and provide access to evidence-based health care services, emphasizing convenient, comprehensive primary care and including preventive, screening and well- child health services.(2) Provide access to appropriate specialty care, mental health services, inpatient services and any evidence-based alternative therapies.(3) Provide quality-driven and cost-effective health care.(4) Provide access to medication and medication therapy management services, in accordance with section 935(c) of the Patient Protection and Affordable Care Act (Public Law 111-148, 42 U.S.C. § 299b-35 (c)).(5) Promote strong and effective medical management, including, but not limited to, planning treatment strategies, monitoring health outcomes and resource use, sharing information and organizing care to avoid duplication of services, including the use of electronic medical records. In sharing information, the protection of the privacy of individuals and of the individuals' information shall be priorities. In addition to any and all other Federal and State provisions for the confidentiality of health care information, any information-sharing required by a medical home system shall be subject to written consent of the patient.(6) Provide comprehensive care management to patients to align and assist with treatment strategies, health outcomes, resource utilization and organization of care and address determinants of health impeding goals of care.(7) Emphasize patient and provider accountability.(8) Prioritize access to the continuum of health care services in the most appropriate setting and in the most cost-effective manner.(9) Establish a baseline for medical home goals and establish performance measures that indicate a patient has an established and effective medical home. These goals and performance measures may include, but need not be limited to, childhood immunization rates, well-child care utilization rates, care management for chronic illnesses and emergency room utilization.(b) Composition.--The secretary shall appoint the members of the council, in consultation with the President pro tempore of the Senate, the Majority Leader of the Senate, the Minority Leader of the Senate, the Speaker of the House of Representatives, the Majority Leader of the House of Representatives and the Minority Leader of the House of Representatives, which shall consist of the secretary or a designee and individuals representing the following interestS:
(2) Obstetricians and gynecologists.(7) Hospital and health systems.(8) Patient-centered medical homes.(9) Mental health care providers.(10) Community health centers.(11) Managed care organizations licensed to do business in the Commonwealth.(12) Physician assistants.(c) Professional organizations representing the professions indicated in subsection (b) may submit names to the secretary for the purpose of being appointed to the council. (d)Terms.--Each member of the council shall serve for a period of two years. Members may be reappointed by the secretary.(e)Meetings.--The department shall establish and coordinate meetings of the council. The secretary, or the secretary's designee, shall serve as chairperson of the council.(f)Expenses.--The members of the council shall not be paid, but shall be reimbursed for reasonable expenses.Added by P.L. TBD 2014 No. 198, § 3, eff. 10/31/2014.