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.