SRC-SLL H.B. 1085 75(R)   BILL ANALYSIS


Senate Research Center   H.B. 1085
By: Maxey (Moncrief)
Health & Human Services
5-5-97
Engrossed


DIGEST

The Department of Human Services (department) was required by the 74th
Legislature to develop an automated system by which nursing facilities
would provide information on Medicaid reimbursements and patient care to
the department.  Reimbursement rates are currently adjusted every six
months.  Moving the department to a quarterly rate adjustment schedule
will result in a reimbursement rate that more accurately reflects the
level of care being provided by the facility. This bill will require
nursing facilities to complete and submit the required information to the
department at least quarterly for reimbursement. 

PURPOSE

As proposed, H.B. 1085 requires nursing facilities to complete and submit
certain information to the Department of Human Services at least quarterly
for reimbursement. 

RULEMAKING AUTHORITY

This bill does not grant any additional rulemaking authority to a state
officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 242H, Health and Safety Code, as follows:

SUBCHAPTER I.  Redesignated from existing Subchapter H.  AUTOMATED
MEDICAID PATIENT CARE AND REIMBURSEMENT SYSTEM 

Sec.  242.221.  AUTOMATED SYSTEM FOR MEDICAID PATIENT CARE AND
REIMBURSEMENT.  Redesignated from existing Section 242.201.  Requires the
Texas Department of Human Services (department) to acquire and develop an
automated system for providing reimbursements to nursing facilities,
rather than nursing homes, under the state Medicaid program, subject to
the availability of funds appropriated for that purpose. Requires the
department to charge a fee to nursing facilities that do not receive their
Medicaid reimbursements electronically.  Requires the department to set
the fee in an amount necessary to cover the costs of manually processing
and sending the reimbursements. 

Sec.  242.222.  DATA USED BY SYSTEM.  Makes conforming changes.

Sec.  242.223.  FREQUENCY OF DATA SUBMISSION.  Requires nursing facilities
to complete and electronically submit the designated form to the
department at least quarterly for reimbursement.  Makes a conforming
change. 

Sec.  242.224.  ELECTRONIC CLAIMS FOR REIMBURSEMENT.  Makes conforming
changes. 

Sec.  242.225.  DATE OF REIMBURSEMENT.  Makes conforming and
nonsubstantive changes. 

Sec.  242.226.  RULES.  Makes a conforming change. 

 SECTION 2. Effective date: September 1, 1997.

SECTION 3. Emergency clause.