By:  Zaffirini, Moncrief, Madla                       S.B. No. 1163

                                A BILL TO BE ENTITLED

                                       AN ACT

 1-1     relating to information and training about Medicaid managed care.

 1-2           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-3           SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,

 1-4     is amended by adding Section 32.043 to read as follows:

 1-5           Sec. 32.043.  MANAGED CARE INFORMATION AND TRAINING PLAN.

 1-6     (a)  The department shall develop a comprehensive plan to provide

 1-7     information and training about the requirements of a managed care

 1-8     plan to recipients of medical assistance, providers of medical

 1-9     assistance, local health and human services agencies, and other

1-10     interested parties in each service area in which the department

1-11     plans to provide medical assistance through a managed care plan.

1-12           (b)  The department shall include in the comprehensive plan:

1-13                 (1)  180 days of initial information and training in a

1-14     service area beginning not later than the 90th day before the date

1-15     on which the department plans to begin to provide medical

1-16     assistance through a managed care plan in that service area;

1-17                 (2)  additional information and training at regular

1-18     intervals determined by the department; and

1-19                 (3)  performance measures to evaluate the effectiveness

1-20     of the information and training.

1-21           (c)  In developing the comprehensive plan, the department

1-22     shall consult with the Medicaid medical care advisory committee.

1-23           (d)  The department shall submit to the lieutenant governor,

 2-1     the speaker of the house of representatives, the Senate Health and

 2-2     Human Services Committee, and the House Public Health Committee a

 2-3     semiannual report on the effectiveness of the comprehensive plan

 2-4     developed under this section.  The department may consolidate this

 2-5     report with any other report relating to the same subject that the

 2-6     department is required to submit under other law.

 2-7           (e)  In conjunction with the comprehensive plan, the

 2-8     department shall establish a pilot project with a duration of not

 2-9     less than two years in a location determined by the department to

2-10     test the effectiveness and cost of peer outreach and health

2-11     education designed to:

2-12                 (1)  inform recipients about the effective use of

2-13     health care resources, including managed care plans and primary

2-14     care providers under those plans; and

2-15                 (2)  encourage recipients to:

2-16                       (A)  seek preventive health care regularly,

2-17     including prenatal care and screening through the early and

2-18     periodic screening, diagnosis, and treatment program;

2-19                       (B)  develop family preventive health care plans;

2-20                       (C)  follow health care providers' instructions;

2-21     and

2-22                       (D)  keep health care appointments and follow up

2-23     on missed appointments.

2-24           SECTION 2.  The importance of this legislation and the

2-25     crowded condition of the calendars in both houses create an

 3-1     emergency and an imperative public necessity that the

 3-2     constitutional rule requiring bills to be read on three several

 3-3     days in each house be suspended, and this rule is hereby suspended,

 3-4     and that this Act take effect and be in force from and after its

 3-5     passage, and it is so enacted.