1-1     By:  Zaffirini, Moncrief                              S.B. No. 1163

 1-2           (In the Senate - Filed March 11, 1997; March 17, 1997, read

 1-3     first time and referred to Committee on Health and Human Services;

 1-4     April 21, 1997, reported adversely, with favorable Committee

 1-5     Substitute by the following vote:  Yeas 10, Nays 0; April 21, 1997,

 1-6     sent to printer.)

 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 1163               By:  Zaffirini

 1-8                            A BILL TO BE ENTITLED

 1-9                                   AN ACT

1-10     relating to information and training about Medicaid managed care.

1-11           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-12           SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,

1-13     is amended by adding Section 32.043 to read as follows:

1-14           Sec. 32.043.  MANAGED CARE INFORMATION AND TRAINING PLAN.

1-15     (a)  The department shall develop a comprehensive plan to provide

1-16     information and training about the requirements of a managed care

1-17     plan to recipients of medical assistance, providers of medical

1-18     assistance, local health and human services agencies, and other

1-19     interested parties in each service area in which the department

1-20     plans to provide medical assistance through a managed care plan.

1-21           (b)  The department shall include in the comprehensive plan:

1-22                 (1)  180 days of initial information and training in a

1-23     service area beginning not later than the 90th day before the date

1-24     on which the department plans to begin to provide medical

1-25     assistance through a managed care plan in that service area;

1-26                 (2)  additional information and training at regular

1-27     intervals determined by the department; and

1-28                 (3)  performance measures to evaluate the effectiveness

1-29     of the information and training.

1-30           (c)  In developing the comprehensive plan, the department

1-31     shall consult with the Medicaid medical care advisory committee.

1-32           (d)  The department shall submit to the lieutenant governor,

1-33     the speaker of the house of representatives, the Senate Health and

1-34     Human Services Committee, and the House Public Health Committee a

1-35     semiannual report on the effectiveness of the comprehensive plan

1-36     developed under this section.  The department may consolidate this

1-37     report with any other report relating to the same subject that the

1-38     department is required to submit under other law.

1-39           (e)  In conjunction with the comprehensive plan, the

1-40     department shall establish a pilot project with a duration of not

1-41     less than two years in a location determined by the department to

1-42     test the effectiveness and cost of peer outreach and health

1-43     education designed to:

1-44                 (1)  inform recipients about the effective use of

1-45     health care resources, including managed care plans and primary

1-46     care providers under those plans; and

1-47                 (2)  encourage recipients to:

1-48                       (A)  seek preventive health care regularly,

1-49     including prenatal care and screening through the early and

1-50     periodic screening, diagnosis, and treatment program;

1-51                       (B)  develop family preventive health care plans;

1-52                       (C)  follow health care providers' instructions;

1-53     and

1-54                       (D)  keep health care appointments and follow up

1-55     on missed appointments.

1-56           SECTION 2.  The importance of this legislation and the

1-57     crowded condition of the calendars in both houses create an

1-58     emergency and an imperative public necessity that the

1-59     constitutional rule requiring bills to be read on three several

1-60     days in each house be suspended, and this rule is hereby suspended,

1-61     and that this Act take effect and be in force from and after its

1-62     passage, and it is so enacted.

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