1-1  By:  Zaffirini, Moncrief                               S.B. No. 600
    1-2        (In the Senate - Filed February 16, 1995; February 16, 1995,
    1-3  read first time and referred to Committee on Health and Human
    1-4  Services; March 16, 1995, reported adversely, with favorable
    1-5  Committee Substitute by the following vote:  Yeas 9, Nays 0;
    1-6  March 16, 1995, sent to printer.)
    1-7  COMMITTEE SUBSTITUTE FOR S.B. No. 600                By:  Zaffirini
    1-8                         A BILL TO BE ENTITLED
    1-9                                AN ACT
   1-10  relating to the development of certain standards and complaint
   1-11  system guidelines for managed care organizations covering Medicaid
   1-12  clients.
   1-13        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-14        SECTION 1.  Subchapter B, Chapter 12, Health and Safety Code,
   1-15  is amended by adding Section 12.017 to read as follows:
   1-16        Sec. 12.017.  MANAGED CARE ORGANIZATIONS:  MEDICAID PROGRAM.
   1-17  (a)  Except as provided by Section 533.045, the department shall
   1-18  develop for managed care organizations that serve Medicaid clients
   1-19  performance, operation, quality of care, marketing, and financial
   1-20  standards and standards relating to children's access to quality
   1-21  health care services.
   1-22        (b)  In establishing standards under this section, the
   1-23  department, to the extent possible, shall ensure that each Medicaid
   1-24  client can receive quality health care services in the client's
   1-25  local community.
   1-26        SECTION 2.  Subchapter B, Chapter 533, Health and Safety
   1-27  Code, is amended by adding Section 533.045 to read as follows:
   1-28        Sec. 533.045.  MANAGED CARE ORGANIZATIONS:  MEDICAID PROGRAM.
   1-29  The department shall develop performance, operation, and financial
   1-30  standards for the provision by managed care organizations of mental
   1-31  health and mental retardation services to Medicaid clients.
   1-32        SECTION 3.  Chapter 1, Insurance Code, is amended by adding
   1-33  Article 1.61 to read as follows:
   1-34        Art. 1.61.  MEDICAID MANAGED CARE ORGANIZATION:  FISCAL
   1-35  SOLVENCY AND COMPLAINT SYSTEM GUIDELINES.  In conjunction with the
   1-36  Texas Department of Health, the department shall establish fiscal
   1-37  solvency standards and complaint system guidelines for managed care
   1-38  organizations that serve Medicaid patients.
   1-39        SECTION 4.  This Act takes effect September 1, 1995.
   1-40        SECTION 5.  The importance of this legislation and the
   1-41  crowded condition of the calendars in both houses create an
   1-42  emergency and an imperative public necessity that the
   1-43  constitutional rule requiring bills to be read on three several
   1-44  days in each house be suspended, and this rule is hereby suspended.
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