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A BILL TO BE ENTITLED
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AN ACT
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relating to a report regarding Medicaid reimbursement rates and |
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access to care. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. (a) In this section, "commission" means the |
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Health and Human Services Commission. |
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(b) The commission shall prepare a written report regarding |
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provider reimbursement rates and access to care under Medicaid. |
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The commission shall collaborate with the medical care advisory |
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committee established under Section 32.022, Human Resources Code, |
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to develop and define the scope of the research for the report. The |
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report must: |
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(1) review the provider reimbursement rates for at |
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least 20 Medicaid-covered services; |
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(2) outline factors of the reimbursement rate |
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methodologies used by Medicaid managed care organizations; |
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(3) propose alternative reimbursement methodologies; |
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(4) evaluate the impact of Medicaid provider |
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reimbursement rates on access to care for Medicaid recipients; |
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(5) compare provider participation in Medicaid by |
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region, particularly increases or decreases in the number of |
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participating providers per year beginning with the state fiscal |
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year ending August 31, 2012, categorized by provider specialty and |
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subspecialty; |
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(6) list to the extent the information is available, |
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for each state fiscal quarter beginning with the first quarter of |
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the state fiscal year ending August 31, 2017: |
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(A) counties in which provider access standards |
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relating to distance have not been met; and |
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(B) counties in which provider access standards |
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relating to travel time have not been met; |
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(7) examine Medicaid directed provider payments and |
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their effect on incentivizing providers to participate or continue |
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participating in Medicaid, including: |
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(A) the uniform hospital rate increase program |
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described by 1 T.A.C. Section 353.1305; |
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(B) the quality incentive payment program |
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(QIPP); and |
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(C) the minimum reimbursement rate for nursing |
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facilities described by Section 533.00251, Government Code; and |
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(8) determine the feasibility and cost of |
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establishing: |
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(A) a minimum fee schedule for Medicaid providers |
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in counties where provider access standards are not being met; and |
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(B) a different reimbursement rate for classes of |
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providers who provide care in a county: |
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(i) located on an international border; or |
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(ii) with a Medicaid population at least 10 |
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percent higher than the statewide average Medicaid population. |
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(c) Not later than December 1, 2022, the commission shall |
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prepare and submit to the legislature the report described by |
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Subsection (b) of this section. Notwithstanding that subsection, |
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the commission is not required to include in the report any |
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information the commission determines is proprietary. |
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SECTION 2. This Act takes effect September 1, 2021. |