LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                              March 29, 1999
  
  
          TO:  Honorable Judith Zaffirini, Chair, Senate Committee on
               Human Services
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  SB1588  by Zaffirini (Relating to fraud control
               procedures for the Medicaid managed care program.), As
               Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  SB1588, As Introduced:  negative impact of $(94,023) through the      *
*  biennium ending August 31, 2001.                                      *
*                                                                        *
*  The bill would make no appropriation but could provide the legal      *
*  basis for an appropriation of funds to implement the provisions of    *
*  the bill.                                                             *
**************************************************************************
  
The bill would amend Chapter 533 of the Government Code to require each
managed care organization contracting with the Health and Human Services
Commission (HHSC) to submit descriptions of any financial or other
business relationship between the managed care organization and any
subcontractors, subcontractor contracts, and the managed care
organization's fraud control plan.  The bill would require each managed
care organization to submit encounter data and to cooperate with HHSC's
Office of Investigations and Enforcement.

The bill would only apply to a contract entered into on or after the
effective date of the Act.  Currently Medicaid managed care
organizations do not have contracts with HHSC.  Managed care contracts
are with the Department of Health and Department of Human Services.
  
General Revenue-Related Funds, Five-Year Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2000                            $(47,579)  *
          *       2001                             (46,444)  *
          *       2002                             (46,444)  *
          *       2003                             (46,444)  *
          *       2004                             (46,444)  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
**************************************************************************
*Fiscal  Probable (Cost) from Probable (Cost) from  Change in Number of  *
* Year      General Revenue     Medicaid Matching  State Employees from  *
*         Fund: GR Match for      Federal Funds           FY 1999        *
*              Medicaid               0555                               *
*                0001                                                    *
*  2000              $(47,579)            $(47,579)                  2.0 *
*  2001               (46,444)             (46,444)                  2.0 *
*  2002               (46,444)             (46,444)                  2.0 *
*  2003               (46,444)             (46,444)                  2.0 *
*  2004               (46,444)             (46,444)                  2.0 *
**************************************************************************
  
Technology Impact
  
Personal computers would be required for the two new full-time equivalent
positions at the Health and Human Services Commission.
  
  
Fiscal Analysis
  
According to the Health and Human Services Commission, the bill would
require HHSC to hire an additional attorney and one support position to
manage the contracts with managed care organizations and their
subcontractors.
  
  
Methodology
  
The estimates assume that one attorney and administrative technician
would be hired by HHSC.  Associated office equipment, travel and
operating costs are included.
  
  
Local Government Impact
  
No significant fiscal implication to units of local government is
anticipated.
  
  
Source Agencies:   
LBB Staff:         JK, TP, AZ