HBA-DMH H.B. 2468 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 2468
By: Chavez
Public Health
3/13/2001
Introduced



BACKGROUND AND PURPOSE 

Residents in the Texas-Mexico border region suffer from inadequate medical
services compared with most other Texans, in part because state child
health plan (CHIP) funds are not equitably distributed.  Physician to
patient ratios are lowest in the border region, rural areas, and inner
cities.  In February 2000, the Health and Human Services Commission (HHSC)
convened the Border Rate Work Group (work group) to study and recommend
solutions regarding Medicaid and CHIP reimbursement rates along the
Texas-Mexico border.  The work group concluded that a lack of access to
health care services along the border has reduced the utilization rates of
health care services in the region, that the border region receives
disproportionately low reimbursement as a result of low utilization rates,
and that CHIP capitation rates do not reflect the current health care
environmental since they are based on past fee for service reimbursement
rates.  The report also found that lower revenue provides a disincentive
for health care providers to locate and remain in the border region.  The
work group recommended increasing CHIP reimbursement rates in this region
to recruit more doctors and to increase access to care.  House Bill 2468
requires the Texas Department of Health to increase CHIP reimbursement
rates for recipients of CHIP in the Texas-Mexico border region to an
adjusted statewide average and provides physicians with a 10 percent bonus
for providing services in the region. 

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 2468 amends the Health and Safety Code to require the Texas
Department of Health (TDH), with the advice from the Border Rate Work
Group, to ensure, not later than September 1, 2001, that any capitation
rate or any fee for service reimbursement rates under the state child
health plan (CHIP) in the Texas-Mexico border region is at least equal to
the statewide CHIP average.  The bill requires TDH to exclude data from the
Texas-Mexico border region in determining the statewide average CHIP
capitation rate and the statewide average expenditure per CHIP enrollee.
The bill requires TDH to ensure that a physician providing a service to a
CHIP enrollee in the Texas-Mexico border region receives a bonus in the
amount of 10 percent of the reimbursement customarily provided to a
physician providing that service in another region of the state.  The bill
authorizes TDH to vary the amount of rate increases for professional
services according to the type of services provided and requires TDH to
develop mechanisms to pass any rate increase directly to health care
providers, regardless of which type of health plan provider is providing
payment.   

EFFECTIVE DATE

September 1, 2001.