Honorable James B. Frank, Chair, House Committee on Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
HB5023 by Guerra (Relating to requiring Medicaid managed care organizations to provide an annual bonus payment to certain Medicaid providers.), As Introduced
The fiscal implications of the bill cannot be determined due to an unknown number of providers who would receive bonus payments, however the bill could have a significant negative fiscal impact to the state.
The bill would require the Health and Human Services Commission (HHSC) to require each Medicaid managed care organization (MCO) to provide an annual bonus payment to providers who provided health care services to recipients within a specified time frame.
The bill would require the bonus payment to be an amount equal to 25.0 percent of the profits the organization made during the preceding fiscal year on services provided by the provider.
According to HHSC, the bill would require a written evaluation plan and federal approval for implementation of the bonus payments. HHSC estimates 1.0 additional full-time equivalent would be required to implement and oversee and the program. The agency does not currently collect information on the timeliness of services provided, as directed in the bill. The agency anticipates collecting the necessary data would increase costs for the state and MCOs. However, the fiscal impact cannot be determined due to a lack of information regarding potential costs associated with new data collecting requirements.
The bill would conflict with current statute and rules related to profit sharing with MCOs and would reduce experience rebate revenue received by the state. While the bill would result in a negative fiscal impact to the state, the fiscal implications cannot be determined due to an unknown number of providers who would receive bonus payments from MCO profits.
Local Government Impact
No fiscal implication to units of local government is anticipated.