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.