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.