HBA-NRS H.B. 1516 77(R)BILL ANALYSIS Office of House Bill AnalysisH.B. 1516 By: Janek Public Health 77/16/2001 Enrolled BACKGROUND AND PURPOSE Patients with catastrophic health problems, such as organ transplants or multiple traumas, represent only a small number of the total Medicaid patient load, but they account for a very large portion of Medicaid 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 will likely 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. House Bill 1516 requires the Health and Human Services Commission to develop and implement a catastrophic case management system to be used in providing Medicaid to persons with catastrophic health problems. 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 House Bill 1516 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to develop and implement a catastrophic case management system to be used in providing Medicaid to persons with catastrophic health problems. The bill establishes that the system must provide for the assignment of a case manager to a Medicaid recipient with catastrophic health problems that are likely to require the service of multiple, specialized health care providers and result in major medical costs. The bill requires HHSC to identify the services to be provided by a case manager, including assessment of the recipient's needs, coordination of all available medical services, and payment options. The bill also authorizes and sets forth other support services. Not later than January 15 of each oddnumbered year, the bill requires HHSC to report to the legislature on the implementation of the system. The report must include a statement of the number of recipients of medical assistance who received catastrophic case management services under the system during the preceding two years and the estimated savings resulting from implementation of the system during the preceding two years. EFFECTIVE DATE September 1, 2001.