BILL ANALYSIS C.S.S.B. 1618 By: Armbrister Economic Development 04-30-95 Committee Report (Substituted) 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 As proposed, C.S.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 grant any additional rulemaking authority to a state officer, institution, or agency. 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.