BILL ANALYSIS


                                                     C.S.S.B. 605
                                                        By: Madla
                                        Health and Human Services
                                                         03-16-95
                                   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.  The 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 pilots
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 Committee on Public Health and Human Services and then
adopted the recommendations that are the basis of this legislation.

PURPOSE

As proposed, C.S.S.B. 605 requires the Texas Department of Mental
Health and Mental Retardation to evaluate and revise its sliding
fee schedules.

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 Section 552.017, Health and Safety Code, by
adding Subsection (e), as follows:

     (e) Requires the Texas Department of Mental Health and Mental
     Retardation (department) to evaluate and, if necessary, revise
     the fee schedule at least once every five years.
     
     SECTION 2.     Amends Section 593.075, Health and Safety Code, by
adding Subsection (e), to make conforming changes.

SECTION 3. Requires the department to evaluate and, if necessary,
revise its sliding fee schedules by January 1, 1996.

SECTION 4. Emergency clause.
           Effective date: upon passage.