BILL ANALYSIS



S.B. 1618
By: Armbrister (Smithee)
05-16-95
Committee Report (Unamended)


BACKGROUND

     Joint Commission for Accreditation of Healthcare Organizations
(JCAHO) accreditation is no longer an enhancement to Medicare
compliance due to changes in the Medicare certification standards
and surveys.  The costs of becoming JCAHO accredited increase the
cost of health care.  Agencies accredited by JCAHO who are not
successful in obtaining managed care contracts are passing the
extra costs of accreditation to Medicare, other third-party
reimbursement sources, and private pay patients.

PURPOSE

     S.B. 1618 requires a health maintenance organization to be
required to accept certification or accreditation of a hospital,
health care facility, health care agency, or health care service;
requires the Texas Department of Human Services to accept licensure
by the Texas Department of Health (TDH) or certification by the
Medicare program; requires a managed health care plan developed by
the Managed Health Care Advisory Committee to include in its
criteria for hospitals, home health care providers, and hospice
providers, acceptance of licensure by TDH or certification by the
Medicare program.

RULEMAKING AUTHORITY

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

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 6(a), Article 20A.06, V.T.I.C. (Texas
Health Maintenance Organization Act), to require a health
maintenance organization to accept the certification or
accreditation, if a hospital, health care facility, health care
agency, or health care supplier is certified by the Medicare
program or accredited by the Joint Commission on Accreditation of
Healthcare Organizations or another national accrediting body.

SECTION 2. Amends Section 14(g), Article 20A.14, V.T.I.C., to make
a conforming change.

SECTION 3. Amends Section 32.027, Human Resources Code, by adding
Subsection (i), to require the Texas Department of Human Services
to accept licensure by the Texas Department of Health (TDH) or
certification by the Medicare program, in its establishment of
provider criteria for hospitals, home health providers, or hospice
providers.

SECTION 4. Amends Section 501.509(g), Government Code, to require
the Managed Health Care Advisory Committee to develop a managed
health care plan for all inmates at the institutional division that
includes, as to the establishment of criteria for hospitals, home
health providers, or hospice providers, acceptance of licensure by
TDH or certification by the Medicare program.

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



SUMMARY OF COMMITTEE ACTION

     Pursuant to an announcement filed with the Journal Clerk and
read by the Reading Clerk, in accordance with House Rules, the
House Committee on Insurance met in a formal meeting on May 16,
1995 at desk #24 on the House Floor and was called to order by the
Chair, Representative John Smithee.

     The Chair laid out S.B. 1618 and recognized Representative G.
Lewis who moved the Committee report S.B. 1618 as engrossed to the
full House with the recommendation that it do  and be printed. 
Representative Driver seconded the motion and the motion prevailed
by the following vote: AYES: (6); NAYES: (0); PNV: (0); ABSENT:
(3).