State Codes and Statutes

Statutes > New-york > Pbh > Article-29-d > Title-3 > 2999-e

* §   2999-e.   Demonstration   projects.   1.   Notwithstanding   any  inconsistent  regulation  of  the  department,   the   commissioner   is  authorized and shall select up to five demonstration projects throughout  the  state,  pursuant  to  a  competitive  bid  or  request for proposal  process, which have been determined by the commissioner to encompass one  or more of the following elements:    (a) use of the workgroup metrics  to  measure  and  reward  physician,  clinic and hospital performance;    (b)  involvement  of  multiple  payers, including government programs,  multiple providers and  multiple  communities  voluntarily  agreeing  to  employ  the  workgroup  metrics to reward physician, clinic and hospital  performance for quality improvement;    (c) use of information technology to share patient  information  among  providers to improve coordination of patient care;    (d)   targeted   improvement   in   care   coordination   through  the  participation of multiple stakeholders;    (e) collection, analysis and public  reporting  on  the  risk-adjusted  measures, incentives and processes utilized, and outcomes; and    (f)  programs  to enhance patient self-management through adherence to  treatment plans.    2. In evaluating proposed  demonstration  projects,  the  commissioner  shall  consider  the  degree  to  which  a proposed project reflects the  elements listed above including demonstrated commitments on the part  of  all practitioners, providers and payors to participate.    3.  (a)  There shall be no more than five demonstration projects under  this title.    (b) Where any demonstration project involves recipients  of  Medicaid,  family  health  plus,  or  child health plus, those recipients shall not  constitute more than half the individuals covered by  the  demonstration  project  and  their  health  care,  measured  in  the  amount  of annual  reimbursement, shall not cover more than half of the health care covered  by the demonstration project.    (c) No demonstration  project  shall  limit  the  scope  or  terms  of  coverage  or  limit  the  grounds  or  procedural rights for appealing a  denial of reimbursement for a health care  service,  for  any  consumer,  enrollee, or recipient subject to the demonstration project.    * NB Expires April 1, 2011

State Codes and Statutes

Statutes > New-york > Pbh > Article-29-d > Title-3 > 2999-e

* §   2999-e.   Demonstration   projects.   1.   Notwithstanding   any  inconsistent  regulation  of  the  department,   the   commissioner   is  authorized and shall select up to five demonstration projects throughout  the  state,  pursuant  to  a  competitive  bid  or  request for proposal  process, which have been determined by the commissioner to encompass one  or more of the following elements:    (a) use of the workgroup metrics  to  measure  and  reward  physician,  clinic and hospital performance;    (b)  involvement  of  multiple  payers, including government programs,  multiple providers and  multiple  communities  voluntarily  agreeing  to  employ  the  workgroup  metrics to reward physician, clinic and hospital  performance for quality improvement;    (c) use of information technology to share patient  information  among  providers to improve coordination of patient care;    (d)   targeted   improvement   in   care   coordination   through  the  participation of multiple stakeholders;    (e) collection, analysis and public  reporting  on  the  risk-adjusted  measures, incentives and processes utilized, and outcomes; and    (f)  programs  to enhance patient self-management through adherence to  treatment plans.    2. In evaluating proposed  demonstration  projects,  the  commissioner  shall  consider  the  degree  to  which  a proposed project reflects the  elements listed above including demonstrated commitments on the part  of  all practitioners, providers and payors to participate.    3.  (a)  There shall be no more than five demonstration projects under  this title.    (b) Where any demonstration project involves recipients  of  Medicaid,  family  health  plus,  or  child health plus, those recipients shall not  constitute more than half the individuals covered by  the  demonstration  project  and  their  health  care,  measured  in  the  amount  of annual  reimbursement, shall not cover more than half of the health care covered  by the demonstration project.    (c) No demonstration  project  shall  limit  the  scope  or  terms  of  coverage  or  limit  the  grounds  or  procedural rights for appealing a  denial of reimbursement for a health care  service,  for  any  consumer,  enrollee, or recipient subject to the demonstration project.    * NB Expires April 1, 2011

State Codes and Statutes

State Codes and Statutes

Statutes > New-york > Pbh > Article-29-d > Title-3 > 2999-e

* §   2999-e.   Demonstration   projects.   1.   Notwithstanding   any  inconsistent  regulation  of  the  department,   the   commissioner   is  authorized and shall select up to five demonstration projects throughout  the  state,  pursuant  to  a  competitive  bid  or  request for proposal  process, which have been determined by the commissioner to encompass one  or more of the following elements:    (a) use of the workgroup metrics  to  measure  and  reward  physician,  clinic and hospital performance;    (b)  involvement  of  multiple  payers, including government programs,  multiple providers and  multiple  communities  voluntarily  agreeing  to  employ  the  workgroup  metrics to reward physician, clinic and hospital  performance for quality improvement;    (c) use of information technology to share patient  information  among  providers to improve coordination of patient care;    (d)   targeted   improvement   in   care   coordination   through  the  participation of multiple stakeholders;    (e) collection, analysis and public  reporting  on  the  risk-adjusted  measures, incentives and processes utilized, and outcomes; and    (f)  programs  to enhance patient self-management through adherence to  treatment plans.    2. In evaluating proposed  demonstration  projects,  the  commissioner  shall  consider  the  degree  to  which  a proposed project reflects the  elements listed above including demonstrated commitments on the part  of  all practitioners, providers and payors to participate.    3.  (a)  There shall be no more than five demonstration projects under  this title.    (b) Where any demonstration project involves recipients  of  Medicaid,  family  health  plus,  or  child health plus, those recipients shall not  constitute more than half the individuals covered by  the  demonstration  project  and  their  health  care,  measured  in  the  amount  of annual  reimbursement, shall not cover more than half of the health care covered  by the demonstration project.    (c) No demonstration  project  shall  limit  the  scope  or  terms  of  coverage  or  limit  the  grounds  or  procedural rights for appealing a  denial of reimbursement for a health care  service,  for  any  consumer,  enrollee, or recipient subject to the demonstration project.    * NB Expires April 1, 2011