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.