SRC-JEC C.S.S.B. 284 77(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 284
By: Nelson
Health & Human Services
4/23/2001
Committee Report (Substituted)


DIGEST AND PURPOSE 

The current Medicaid managed care reporting system can be onerous and
difficult to navigate due to the number of health plans involved in the
delivery of services.  C.S.S.B. 284 requires the Health and Human Services
Commission to study methods to streamline the reports required of health
care providers to reduce the administrative burden placed on providers'
practices, and to make recommendations to implement certain practices.  It
also requires an interagency memorandum of understanding and the creation
of a single audit instrument. 

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 533A, Government Code, to add Sections 533.0055,
533.016, 533.017, and 533.018, as follows: 

Sec. 533.0055.  EVALUATION OF REPORTING REQUIREMENTS AND INSPECTION
PROCEDURES.  (a) Requires the Health and Human Services Commission or an
agency operating part of the state Medicaid managed care program, as
appropriate (commission), to:   

(1)  evaluate on-site inspection procedures of managed care organizations
contracting with the commission under this chapter and evaluate methods to
streamline those procedures to assist the commission in determining
necessary and effective quality control measures and required data; 

(2)  evaluate methods to streamline reporting requirements for managed care
organizations contracting with the commission under this chapter, including
certain methods; and 

(3)  require managed care organizations contracting with the commission
under this chapter to evaluate reporting requirements for health care
providers to identify methods of reducing the administrative burden placed
on the providers, including certain methods. 

(b)  Requires the commission to submit a report to the legislature
regarding the evaluation of and methods for streamlining on-site inspection
procedures and reporting requirements for managed care organizations and
health care providers providing health care services to recipients.
Requires the report to include recommendations on which methods should be
implemented and a schedule for implementation. 

  (c)  Provides that this section expires September 1, 2002.
 
Sec. 533.016.  INTERAGENCY SHARING OF INFORMATION.  Requires the commission
to require a health and human services agency implementing the Medicaid
managed care program to provide to each other health and human services
agency implementing the Medicaid managed care program information reported
to that agency by a managed care organization or health care provider
providing services to recipients. 

Sec. 533.017.  INTERAGENCY MEMORANDUM OF UNDERSTANDING.  Requires the chief
executive officers of the commission, the Texas Department of Insurance,
and, if appropriate, health and human services agencies, to execute and
provide to all Medicaid health maintenance organizations interagency
memoranda of understanding that maximize interagency coordination and
eliminate existing and prevent future duplicative monitoring, regulation,
and enforcement policies and processes. 

Sec. 533.018.  SINGLE AUDIT INSTRUMENT.  (a) Requires the commission and
the Texas Department of Insurance to develop a single audit instrument to
be used by the commission, health and human services agencies, and their
contractors, and the Texas Department of Insurance and its contractors for
regularly scheduled, comprehensive, on-site readiness, performance,
compliance, or other reviews, audits, and examinations of Medicaid health
maintenance organizations, and specify in detail the process the agencies
shall use to amend the single audit instrument. 

(b) Requires the single audit instrument to be developed by the commission
and the Texas Department of Insurance to include certain elements. 

SECTION 2.  Requires the Health and Human Services Commission and the Texas
Department of Insurance to complete the interagency memorandum of
understanding and the single audit instrument as required by this Act not
later than November 30, 2001. 

SECTION 3.  Requires the Health and Human Services Commission to submit the
report to the legislature as required by this Act not later than November
1, 2002.  

SECTION 4.  Effective date:  upon passage or September 1, 2001.

SUMMARY OF COMMITTEE CHANGES

Differs from the original by proposing Sections 533.017 and 533.018 and by
including the deadline for the completion of the interagency memorandum of
understanding and the single audit instrument.