LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  May 16, 1997
         
         
      TO: Honorable Judith Zaffirini, Chair            IN RE:  House Bill No. 2913, As Engrossed
          Committee on Health & Human Services                              By: Berlanga
          Senate
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on HB2913 ( Relating 
to the authority of the Health and Human Services Commission 
to administer and operate the Medicaid managed care program.) 
this office has detemined the following:
         
         Biennial Net Impact to General Revenue Funds by HB2913-As Engrossed
         
No significant fiscal implication to the State is anticipated. 
 
         
The bill would make no appropriation but could provide the legal 
basis for an appropriation of funds to implement the provisions 
of the bill.
         
 
Fiscal Analysis

The bill would amend current law governing 
the development of the health and human service delivery system 
by the Health and Human Services Commission (HHSC).  The bill 
would require HHSC to include certain considerations related 
to Medicaid managed care contracts to providers; ensure that 
Medicaid recipients are aware of care options available; ensure 
that contracting organization develop special disease management 
programs for conditions such as asthma and diabetes; contract 
with managed care organizations that are created by a political 
subdivision and that are obligated to provide indigent health 
care; appoint regional Medicaid Managed Care Advisory Committees; 
direct the Department of Health (TDH) and Department of Human 
Services (DHS) to submit a plan to the Governor and Legislative 
Budget Board that would realize cost savings for the state by 
simplifying eligibility criteria and streamlining eligibility 
processes for recipients of public assistance; and provide a 
number of reports related to Medicaid managed care implementation 
to the Governor, Lieutenant Governor and Speaker of the House 
of Representatives. The bill would also make HHSC responsible 
for adopting rules related to setting rates, charges, and fees 
for medical assistance payments.    
 
Methodology
 
Since 
the bill gives HHSC the authority to supervise employees of 
health and human services agencies, it is assumed that HHSC 
would delegate responsibilities to employees of TDH and DHS 
in carrying out the provisions of the bill.  It is estimated 
that implementing the provisions of the bill would cost $97,788 
in General Revenue Related Funds for the 1998-1999 biennium, 
but these costs could be absorbed within existing resources. 
                

It is assumed that HHSC would delegate most 
of the rate-setting functions to the health and human services 
agencies that currently set Medicaid rates or transfer employees 
and equipment from those agencies.
          
No significant fiscal implication to units of local government 
is anticipated.
          
   Source:            Agencies:   529   Health and Human Services Commission
                                         
                      LBB Staff:   JK ,BB