§ 2999-E — Demonstration projects

* § 2999-e. Demonstration projects. 1. Notwithstanding any\ninconsistent regulation of the department, the commissioner is\nauthorized and shall select up to five demonstration projects throughout\nthe state, pursuant to a competitive bid or request for proposal\nprocess, which have been determined by the commissioner to encompass one\nor more of the following elements:\n (a) use of the workgroup metrics to measure and reward physician,\nclinic and hospital performance;\n (b) involvement of multiple payers, including government programs,\nmultiple providers and multiple communities voluntarily agreeing to\nemploy the workgroup metrics to reward physician, clinic and hospital\nperformance for quality improvement;\n (c) use of information technology to share patient information among\nproviders to improve coordination of patient care;\n (d) targeted improvement in care coordination through the\nparticipation of multiple stakeholders;\n (e) collection, analysis and public reporting on the risk-adjusted\nmeasures, incentives and processes utilized, and outcomes; and\n (f) programs to enhance patient self-management through adherence to\ntreatment plans.\n 2. In evaluating proposed demonstration projects, the commissioner\nshall consider the degree to which a proposed project reflects the\nelements listed above including demonstrated commitments on the part of\nall practitioners, providers and payors to participate.\n 3. (a) There shall be no more than five demonstration projects under\nthis title.\n (b) Where any demonstration project involves recipients of Medicaid,\nfamily health plus, or child health plus, those recipients shall not\nconstitute more than half the individuals covered by the demonstration\nproject and their health care, measured in the amount of annual\nreimbursement, shall not cover more than half of the health care covered\nby the demonstration project.\n (c) No demonstration project shall limit the scope or terms of\ncoverage or limit the grounds or procedural rights for appealing a\ndenial of reimbursement for a health care service, for any consumer,\nenrollee, or recipient subject to the demonstration project.\n * NB Expired April 1, 2011\n