By: Rabuck H.B. No. 1633 73R5575 CBH-F A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the payment rates for Medicaid services provided by 1-3 certain providers. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Section 32.028, Human Resources Code, is amended 1-6 by adding Subsections (e), (f), and (g) to read as follows: 1-7 (e) The department in its adoption of reasonable rules and 1-8 standards governing the determination of rates shall provide for a 1-9 higher payment rate for a provider who: 1-10 (1) is practicing privately in a rural area or 1-11 medically underserved area in which there is a documented health 1-12 manpower shortage; and 1-13 (2) provides at least 10 percent of the provider's 1-14 services to recipients of medical assistance under this chapter. 1-15 (f) In determining payment rates under Subsection (e), the 1-16 department shall: 1-17 (1) use a system that is resource-based and considers 1-18 practice expenses, estimated work intensity, education, training, 1-19 and liability insurance; 1-20 (2) use current information, to the extent possible; 1-21 and 1-22 (3) work with appropriate provider organizations to 1-23 collect information. 1-24 (g) The department in its adoption of reasonable rules and 2-1 standards governing the determination of rates paid to a person 2-2 recognized as an advanced nurse practitioner by the Board of Nurse 2-3 Examiners shall establish payment differentials from physicians 2-4 that are resource-based and consider practice expenses, estimated 2-5 work intensity, education, training, and liability insurance. 2-6 SECTION 2. (a) The Texas Department of Human Services or 2-7 its successor in function shall conduct a study to: 2-8 (1) determine the appropriate payment rates for all 2-9 categories of advanced nurse practitioners; 2-10 (2) find ways to address access to care for persons 2-11 eligible for medical assistance under Chapter 32, Human Resources 2-12 Code, considering the extent to which advanced nurse practitioners 2-13 have expanded access to services in rural and underserved areas; 2-14 and 2-15 (3) determine the cost-effectiveness of using advanced 2-16 nurse practitioners and the effect the use will have on patient 2-17 care, including continuity of care. 2-18 (b) The Texas Department of Human Services or its successor 2-19 in function shall complete the study under Subsection (a) of this 2-20 section not later than June 1, 1994. The department shall prepare 2-21 a report detailing the results of the study and shall submit a copy 2-22 of the report to the governor and the legislature. The department 2-23 or its successor in function shall use the study and the report to 2-24 develop the payment rates required by Sections 32.028(e)-(g), Human 2-25 Resources Code, as added by this Act. 2-26 SECTION 3. (a) This Act takes effect September 1, 1993. 2-27 (b) The Texas Department of Human Services or its successor 3-1 in function shall adopt rules as required by Sections 3-2 32.028(e)-(g), Human Resources Code, as added by this Act, not 3-3 later than September 1, 1994. 3-4 SECTION 4. The importance of this legislation and the 3-5 crowded condition of the calendars in both houses create an 3-6 emergency and an imperative public necessity that the 3-7 constitutional rule requiring bills to be read on three several 3-8 days in each house be suspended, and this rule is hereby suspended.