S.B. No. 604
AN ACT
1-1 relating to a pilot program for the establishment of medical
1-2 savings accounts to assist Medicaid recipients.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. MEDICAID MEDICAL SAVINGS ACCOUNT PILOT PROGRAM.
1-5 (a) Not later than December 1, 1995, the Health and Human Services
1-6 Commission shall develop a plan for a pilot program that uses
1-7 Medicaid funds to establish medical savings accounts for recipients
1-8 of acute care services under the state Medicaid program.
1-9 (b) The goals of the pilot program are to:
1-10 (1) create patient awareness of the high cost of
1-11 medical care;
1-12 (2) provide incentives to patients to seek preventive
1-13 and primary care services;
1-14 (3) reduce inappropriate use of health care services;
1-15 and
1-16 (4) enable clients to take responsibility for healthy
1-17 outcomes.
1-18 (c) The commission may examine each available medical
1-19 savings account model to determine if the model can be used in this
1-20 state.
1-21 (d) In developing the pilot program, the commission may
1-22 provide that:
1-23 (1) providers receive payment at a negotiated rate for
1-24 each patient;
2-1 (2) the savings realized by the pilot program are
2-2 shared by the provider, client, and this state;
2-3 (3) the client's share of the savings is placed in a
2-4 savings pool and credited to an individual medical savings account
2-5 established by the provider for that client, provided that certain
2-6 health maintenance standards are met;
2-7 (4) copayments and deductibles for inappropriate use
2-8 of health care are paid by deducting an amount prescribed by the
2-9 commission from the client's individual medical savings account;
2-10 and
2-11 (5) bonus deposits are credited to a client's
2-12 individual medical savings account for achieving health maintenance
2-13 standards prescribed by the commission.
2-14 (e) The commission shall:
2-15 (1) determine the size and location of each pilot
2-16 program;
2-17 (2) include urban and rural counties in determining
2-18 location;
2-19 (3) develop health maintenance standards for each life
2-20 cycle for use in determining if money should be credited to or
2-21 deducted from an individual medical savings account;
2-22 (4) determine the amount of each bonus payment and
2-23 deduction from an individual medical savings account;
2-24 (5) determine the appropriate method, other than a
2-25 cash payment, for releasing to a client money in an individual
2-26 medical savings account when the person no longer participates in
2-27 the Medicaid program;
3-1 (6) exclude medical savings account funds in
3-2 determining income, assets, or resources for purposes of
3-3 eligibility for a public benefits program in this state, regardless
3-4 of whether the funds are used by the household; and
3-5 (7) design the program so that the state controls the
3-6 costs associated with the Medicaid program and, to the extent
3-7 possible, saves money.
3-8 (f)(1) Except as otherwise provided by this subsection, the
3-9 commission shall implement the pilot program not later than
3-10 January 1, 1997.
3-11 (2) The commission may choose not to implement the
3-12 pilot program if the commission or the commission's designee
3-13 determines that the pilot program will not result in any cost
3-14 savings to the state during the next five years.
3-15 (3) If the commission or the commission's designee
3-16 decides not to implement the provisions of this Act, it will report
3-17 its findings to the governor, lieutenant governor, speaker of the
3-18 house of representatives, chair of the Senate Health and Human
3-19 Services Committee, and the chair of the House Public Health
3-20 Committee. The report shall include:
3-21 (A) the concept paper drafted to develop and
3-22 implement the pilot program;
3-23 (B) any fiscal implications and specific
3-24 methodologies used in determining the fiscal implications of
3-25 implementing the pilot program; and
3-26 (C) the basis for the determination that the
3-27 pilot program will not result in any cost savings to the state.
4-1 SECTION 2. REPORT. Not later than January 15, 1999, the
4-2 Health and Human Services Commission shall submit to the governor
4-3 and the 76th Legislature a report concerning the effectiveness of
4-4 the pilot program.
4-5 SECTION 3. WAIVERS. If, before implementing Section 1 of
4-6 this Act, the Health and Human Services Commission determines that
4-7 a waiver or authorization from a federal agency is necessary for
4-8 implementation, the commission shall request the waiver or
4-9 authorization and may delay implementing those provisions until the
4-10 waiver or authorization is granted.
4-11 SECTION 4. EXPIRATION DATE. This Act expires September 1,
4-12 1999.
4-13 SECTION 5. EMERGENCY. The importance of this legislation
4-14 and the crowded condition of the calendars in both houses create an
4-15 emergency and an imperative public necessity that the
4-16 constitutional rule requiring bills to be read on three several
4-17 days in each house be suspended, and this rule is hereby suspended,
4-18 and that this Act take effect and be in force from and after its
4-19 passage, and it is so enacted.