SRC-AXB C.S.S.B. 1588 76(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 1588
76R10756  DLF-DBy: Zaffirini
Human Services
4/1/1999
Committee Report (Substituted)


DIGEST 

Texas expended $7.3 billion in 1997 on its Medicaid program.  The 75th
Legislature directed the comptroller of public accounts to study the size
and nature of fraud and overpayments in the Medicaid program and other
state health care programs. C.S.S.B. 1588 requires managed care
organizations to cooperate with Heath and Human Services Commission
investigations. 

PURPOSE

As proposed, C.S.S.B. 1588 requires managed care organizations (MCO) to
submit certain information to the Health and Human Services Commission
(HHSC), and requires MCOs to cooperate with HHSC investigations. 

RULEMAKING AUTHORITY

This bill does not grant any additional rulemaking authority to a state
officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 533A, Government Code, by adding Section
533.012, as follows: 

Sec.  533.012.  INFORMATION FOR FRAUD CONTROL.  Requires each managed care
organization (MCO) to submit certain documents to the Health and Human
Services Commission (HHSC).  Requires submitted information to be in an
HHSC prescribed form. Requires information to be updated.  Requires the
HHSC office of investigations and enforcement to review submitted
information for fraud in the Medicaid managed care program, as appropriate.
Authorizes the comptroller to review the information. 

SECTION 2.  Amends Section 533.005, Government Code, to require a contract
between an MCO and HHSC to contain a requirement that the MCO provide
required information, and comply with HHSC investigations and enforcement. 

SECTION 3.Effective date:  September 1, 1999.

SECTION 4.  Makes application of this Act prospective.

SECTION 5.  Emergency clause.

SUMMARY OF COMMITTEE CHANGES

SECTION 1.

Amends Section 533.012, Government Code, to delete existing Subsection (b),
and reletter the remaining subsections.  Makes a nonsubstantive change. 

SECTION 3.

 Creates an effective date of September 1, 1999, rather than upon passage.

 SECTIONS 4 and 5.

Redesignated from existing SECTIONS 3 and 4.  Makes conforming and
nonsubstantive changes.