BILL ANALYSIS


                                                     C.S.S.B. 602
                                                    By: Zaffirini
                                        Health and Human Services
                                                          3-16-95
                                   Committee Report (Substituted)
BACKGROUND

The Texas Medicaid program has grown from a total budget of $7.5
billion in the 1990-91 biennium to an appropriation of $18.7
billion for the current 1994-95 biennium, including $6.8 billion in
general revenue and $11.9 billion in federal funds.  This growth is
due to federal mandates regarding eligibility expansions, mandatory
services, and provider reimbursement rules.  Although caseload
growth in the program slowed recently, the demand for new state
funds for Medicaid in the 1996-97 biennium will be approximately
$2.2 billion.

Lt. Gov. Bob Bullock charged the Senate Committee on Health and
Human Services with the challenging task of developing
recommendations for wholesale reform.  In response the committee
began an intensive investigation that included a public hearing on
May 31-June 1, 1994; on-site visits to Medicaid managed care pilot
projects in Texas, to a facility for persons with mental
retardation, to special homes for children, to a rural health
clinic, and to a rehabilitation center; and a second hearing on
November 29-30, 1994.  The committee heard public testimony with
the House Committees on Public Health and on Human Services and
then adopted the recommendations that are the basis of this
legislation.

PURPOSE

As proposed, C.S.S.B. 602 requires the development and
implementation of a health care database to detect fraud
perpetrated by a program provider or client.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not grant any
additional rulemaking authority to a state officer, institution, or
agency.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Article 4413(502), V.T.C.S., by adding Section
16A, as follows:

     Sec. 16A.  MEDICAID DATA COLLECTION SYSTEM. (a) Requires the
     Health and Human Services Commission (commission) and each
     health and human services agency that administers a part of
     the state Medicaid program to jointly develop a system to
     coordinate and integrate state Medicaid databases (system) to
     facilitate the analysis of Medicaid data and detect fraud.
     
     (b) Requires the commission, to minimize cost and
       duplication of activities, to assist and coordinate the
       efforts of participating agencies in the development of the
       system and involved in health-related computer database
       activities provided for by legislation enacted by the 74th
       Legislature.
       
       (c) Requires a state agency that administers any part of the
       state Medicaid program to assist the commission in
       developing the system on the request of the commissioner of
       health and human services.
SECTION 2. Effective date: September 1, 1995.

SECTION 3. Emergency clause.