BILL ANALYSIS



S.B. 604
By: Nelson, et al. (Berlanga, et al.)
04-27-95
Committee Report (Unamended)


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 $11.7 billion in federal funds.  This growth is
due to federal mandates regarding eligibility expansions, required
services, and provider reimbursement rules.

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 May
31-June 1, 1994, and on-site visits to Medicaid managed care pilot
projects in Texas, to a rural health clinic, and to a
rehabilitation center. On November 29-30, 1994, the House
Committees on Public Health and on Human Services joined the Senate
committee in a second public hearing in which public testimony was
taken. The Senate Committee on Health and Human Services then
adopted the recommendations that are the basis of this legislation.

PURPOSE

S.B. 604, as engrossed, would create a pilot program for the
establishment of medical savings accounts to assist Medicaid
recipients.

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. MEDICAID MEDICAL SAVINGS ACCOUNT PILOT PROGRAM.
(a)  Requires the Health and Human Services Commission
(commission) to develop a pilot program (program) that uses
Medicaid funds to establish medical savings accounts for
recipients of acute care services under the state Medicaid
program, not later than December 1, 1995.

     (b)  Sets forth the goals of the program.
     
     (c)  Authorizes the commission to examine each available
     medical savings account model to determine if the model can be
     used in this state.
     
     (d)  Sets forth provisions the commission may provide in
     developing the pilot program.
     
     (e)  Establishes the determinations regarding the program
     which the commission is required to make.
     
     (f)  Requires the commission to implement the program not
     later than January 1, 1997.  Authorizes the commission to
     choose not to implement the program under certain conditions. 
     Sets forth the required contents and a list of persons who are
     to receive a report explaining why the program will not be
     implemented.
     
SECTION 2. REPORT.  Requires the commission to submit to the
governor and the 76th Legislature a report concerning the
effectiveness of the pilot program, not later than January 15,
1999.

SECTION 3. WAIVERS. Requires the commission to request a waiver
or authorization and to delay implementing those provisions until
the waiver or authorization is granted, if the commission
determines that a waiver or authorization from a federal agency
is necessary for implementation.

SECTION 4. EXPIRATION DATE.  Provides that this Act expires
September 1, 1999.

SECTION 5. Emergency clause.
           Effective date: upon passage.

SUMMARY OF COMMITTEE ACTION

S.B. 604 was considered by the Public Health Committee in a
formal meeting April 27, 1995.
The bill was reported favorably without amendment, and with the
recommendation that it do pass and be printed, by a record vote
of 9 Ayes, 0 Nays, 0 PNV, and 0 Absent.