SRC-MKV H.B. 1516 77(R)   BILL ANALYSIS


Senate Research Center   H.B. 1516
77R3328 KKA-DBy: Janek (Nelson)
Health & Human Services
5/1/2001
Engrossed


DIGEST AND PURPOSE 

Patients with catastrophic health problems, such as organ transplants or
multiple traumas, represent only a small number of the total medical
assistance program patient load, but they account for a very large portion
of the medical assistance program's expenses. Such patients require
multiple, specialized providers of health care and expensive medical
procedures. The rapid assignment of a case manager to a patient with
catastrophic health problems will likely result in the patient receiving
the most appropriate and cost-effective services and may prevent the
patient from missing out on needed financial and medical services. Case
managers routinely make arrangements with medical facilities, sort out
travel and lodging options, contact support groups, and educate patients
and their families about the nature of the patient's illness or injury.
H.B. 1516 requires the Health and Human Services Commission to develop and
implement a catastrophic case management system to be used in providing
medical assistance to persons with catastrophic health problems.  

RULEMAKING AUTHORITY

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

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 32B, Human Resources Code, by adding Section
32.053, as follows: 

Sec. 32.053.  CATASTROPHIC CASE MANAGEMENT.  (a) Requires the Health and
Human Services Commission or an agency operating part of the medical
assistance program (department) to develop and implement a catastrophic
case management system (system) to be used in providing medical assistance
to persons with catastrophic health problems. 

(b) Requires the system to provide for the assignment of a case manager to
a recipient of medical assistance with catastrophic health problems that
are likely to require the services of multiple, specialized health care
providers and result in major medical costs. 

(c) Requires the department to identify the services to be provided by a
case manager assigned under the system.  Requires the services to include
assessment of the recipient's needs and coordination of all available
medical services and payment options.  Authorizes the services to include
certain other support services. 

(d) Requires the department, not later than January 15 of each odd-numbered
year, to report to the legislature on the implementation of the system.
Requires the report to include certain information. 

SECTION 2.  Requires a state agency affected by a provision of this Act to
request a waiver or authorization and authorizes the agency to delay
implementing that provision until the waiver or authorization is granted,
if the agency determines before implementing any provision of this Act that
a waiver or authorization from a federal agency is necessary. 
 
SECTION 3.  Effective date: September 1, 2001.