By Harris                                        S.R. No. 136

      75R5377 RNS-D                           

                                 R E S O L U T I O N

 1-1           WHEREAS, Senate Bill 10, 74th Legislature, Regular Session,

 1-2     1995, directed the Texas Health and Human Services Commission to

 1-3     implement a managed care program for Texas Medicaid beneficiaries;

 1-4     and

 1-5           WHEREAS, Although Medicaid managed care offers certain

 1-6     advantages over the traditional fee-for-service system, there is

 1-7     widespread concern that managed care organizations may be tempted

 1-8     to deny necessary services in an effort to operate within the

 1-9     traditionally low reimbursement rates of the Texas Medicaid

1-10     program; moreover, this concern was echoed in an independent

1-11     evaluation of the LoneSTAR pilot programs, and the evaluators urged

1-12     the state to develop its own quality assurance program because

1-13     "relying on health plans to head this effort may not be sufficient

1-14     without a proactive role by the State"; and

1-15           WHEREAS, Senate Bill 601, 74th Legislature, Regular Session,

1-16     1995, responded to these concerns by directing the commission to

1-17     provide support and information services to any person enrolled in

1-18     or applying for Medicaid coverage who experiences barriers to

1-19     receiving health care services; and

1-20           WHEREAS, To date, the commission has failed in its duty to

1-21     implement this directive of Senate Bill 601; any delay whatsoever

1-22     in implementing such basic protections is  inexcusable and must be

1-23     remedied immediately; now, therefore, be it

1-24           RESOLVED, That the Senate of the 75th Texas Legislature

 2-1     hereby  direct the Texas Health and Human Services Commission to

 2-2     immediately take steps to provide support and information services

 2-3     to persons enrolled in Medicaid managed care programs, pursuant to

 2-4     the clear mandate of Senate Bill 601, 74th Legislature, Regular

 2-5     Session, 1995; and, be it further

 2-6           RESOLVED, That the secretary of state forward an official

 2-7     copy of this resolution to the commissioner of the Texas Health and

 2-8     Human Services Commission as an expression of the will of the Texas

 2-9     Senate.