HBA-DMH C.S.H.B. 896 77(R) BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 896 By: Coleman Public Health 5/15/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE Recent advancements in HIV and AIDS treatment have brought renewed health to many people living with HIV and AIDS. However, treatment is expensive. When limited income individuals with HIV or AIDS do not receive appropriate treatment, they debilitate physically to the point where they qualify for disability related Medicaid, one of the most expensive categories of Medicaid coverage. Investing up front in appropriate maintenance care for this population would reduce such costs. In 1997, the legislature directed the Health and Human Services Commission (HHSC) to maximize federal funding under Medicaid for treatment of HIV and AIDS. C.S.H.B. 896 requires HHSC to develop a demonstration project to offer pharmaceutical treatment and medical services under Medicaid to HIV and AIDS patients, and requires HHSC to report on the cost-effectiveness of the project. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS C.S.H.B. 896 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to establish in at least two counties with a high prevalence of HIV infection or AIDS a demonstration project (project) to provide persons with HIV infection or AIDS with medical services, drug treatments and medications, vaccinations, hospitalization, and diagnostic testing and services through the medical assistance program. The bill requires HHSC to ensure that the project is financed using funds made available by the counties in which HHSC establishes the project. The bill establishes eligibility requirements for project participants, provides that project participation does not entitle a participant to other services provided under the medical assistance program, requires HHSC to establish an enrollment process for the project, and sets forth provisions regarding enrollment and eligibility. The bill requires HHSC to submit a biennial report to the legislature no later than December 1 of each even numbered year, and to evaluate the project's cost-effectiveness no later than December 1, 2006. If the evaluation results indicate that the project is cost-effective, HHSC is required to incorporate a request for funding for the expansion of the project in its request for the next state fiscal biennium. The project expires September 1, 2007. EFFECTIVE DATE On passage, or if the Act does not receive the necessary vote, the Act takes effect September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 896 differs from the original bill by removing the provision that demonstration project (project) participants are not subject to the monthly three-prescription limit under the medical assistance program and by providing that project participation does not entitle a participant to other services provided under the medical assistance program. The substitute modifies the eligibility requirements for the project, includes provisions relating to an enrollment process for participants, and requires the Health and Human Services Commission to ensure that county funds are used to finance the project. The substitute modifies the types of services and medications that the project is required to provide. The substitute modifies requirements for requesting a federal waiver or authorization and modifies the effective date of the Act.