By Zaffirini, et al. S.B. No. 1165
75R5912 KKA-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to managed care under the state Medicaid program for
1-3 children with special health care needs.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 ARTICLE 1
1-6 SECTION 1.01. Section 16A, Article 4413(502), Revised
1-7 Statutes, is amended by amending Subsection (n) and adding
1-8 Subsections (o) and (p) to read as follows:
1-9 (n) The commission may not require a child with special
1-10 health care needs who is eligible for medical assistance under
1-11 Chapter 32, Human Resources Code, to enroll in a managed care plan
1-12 to receive health care services. In cooperation with the Texas
1-13 Department of Health, the commission shall:
1-14 (1) monitor and assess health care services provided
1-15 to children with special health care needs who voluntarily receive
1-16 services under a managed care plan;
1-17 (2) adopt specific quality of care standards
1-18 applicable to health care services provided under managed care
1-19 plans to children with special health care needs; and
1-20 (3) develop managed care pilot programs designed for
1-21 children with special health care needs.
1-22 (o) The commission by rule shall prescribe qualifications
1-23 for classification of a child as a "child with special health care
1-24 needs" for purposes of Subsection (n) of this section. In
2-1 prescribing qualifications, the commission must include children
2-2 with:
2-3 (1) severe disabilities;
2-4 (2) medically complex or fragile conditions; and
2-5 (3) rare, complex, or chronic health care conditions
2-6 that are likely to last at least one year and result in limitations
2-7 of function and activities in comparison with healthy children of
2-8 the same age.
2-9 (p) This section expires September 1, 2001.
2-10 ARTICLE 2
2-11 SECTION 2.01. Subchapter B, Chapter 532, Government Code, as
2-12 added by Acts of the 75th Legislature, Regular Session, 1997,
2-13 relating to nonsubstantive additions to and corrections in enacted
2-14 codes, is amended by adding Section 532.112 to read as follows:
2-15 Sec. 532.112. CHILDREN WITH SPECIAL HEALTH CARE NEEDS. (a)
2-16 The commission may not require a child with special health care
2-17 needs who is eligible for medical assistance under Chapter 32,
2-18 Human Resources Code, to enroll in a managed care plan to receive
2-19 health care services.
2-20 (b) In cooperation with the Texas Department of Health, the
2-21 commission shall:
2-22 (1) monitor and assess health care services provided
2-23 to children with special health care needs who voluntarily receive
2-24 services under a managed care plan;
2-25 (2) adopt specific quality of care standards
2-26 applicable to health care services provided under managed care
2-27 plans to children with special health care needs; and
3-1 (3) develop managed care pilot programs designed for
3-2 children with special health care needs.
3-3 (c) The commission by rule shall prescribe qualifications
3-4 for classification of a child as a "child with special health care
3-5 needs" for purposes of this section. In prescribing
3-6 qualifications, the commission must include children with:
3-7 (1) severe disabilities;
3-8 (2) medically complex or fragile conditions; and
3-9 (3) rare, complex, or chronic health care conditions
3-10 that are likely to last at least one year and result in limitations
3-11 of function and activities in comparison with healthy children of
3-12 the same age.
3-13 (d) This section expires September 1, 2001.
3-14 ARTICLE 3
3-15 SECTION 3.01. Article 1 of this Act takes effect only if
3-16 H.B. No. 1845 or S.B. No. 898, Acts of the 75th Legislature,
3-17 Regular Session, 1997, relating to nonsubstantive additions to and
3-18 corrections in enacted codes, does not take effect.
3-19 SECTION 3.02. Article 2 of this Act takes effect only if
3-20 H.B. No. 1845 or S.B. No. 898, Acts of the 75th Legislature,
3-21 Regular Session, 1997, relating to nonsubstantive additions to and
3-22 corrections in enacted codes, takes effect.
3-23 SECTION 3.03. This Act takes effect September 1, 1997.
3-24 SECTION 3.04. The importance of this legislation and the
3-25 crowded condition of the calendars in both houses create an
3-26 emergency and an imperative public necessity that the
3-27 constitutional rule requiring bills to be read on three several
4-1 days in each house be suspended, and this rule is hereby suspended.