SRC- CTC C.S.S.B. 1053 77(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 1053
77R13361 SGA-DBy: Shapleigh
Health & Human Services
4/19/2001
Committee Report (Substituted)


DIGEST AND PURPOSE 

Currently, the Medicaid reimbursement and Children's Health Insurance
Program (CHIP) capitation rates for the 43 border counties are
significantly lower than those of other counties in the state.  Border
counties are some of the poorest in the state, and these counties have been
unable to build an adequate health infrastructure, resulting in barriers to
access of health care services and a lower historical utilization of
services.  Since the historical utilization of services is a significant
factor in Medicaid reimbursement and the original CHIP capitation rates,
border healthcare providers have disproportionately lower reimbursement and
capitation rates for professional services.  C.S.S.B. 1053 requires the
Health and Human Services Commission to increase the Medicaid reimbursement
rate and to provide a financial incentive to physicians who provide
services to certain Medicaid and CHIP enrollees in the Texas-Mexico border
region. 

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 531B, Government Code, by adding Section
531.0221, as follows: 

Sec. 531.0221.  RATES AND EXPENDITURES IN TEXAS-MEXICO BORDER REGION.  (a)
Defines "child health plan program," "committee," and "Texas-Mexico border
region." 

(b)  Requires the commissioner of health and human services (commissioner)
to appoint an advisory committee (committee) to develop a strategic plan
for eliminating disparities between the Texas-Mexico border region and
other areas of the state in certain areas. 

(c)  Requires the committee to periodically perform the research necessary
to analyze and compare the rates and expenditures described by Subsection
(b) and, not later than the date specified by the commissioner, produce a
report based on the results of that analysis and comparison. 

(d)  Requires the committee, as a part of the report required by Subsection
(c), to make recommendations to the commissioner for addressing the
problems created by disparities documented in the report, including
recommendations for allocation of funds. 

(e)  Requires the commissioner to appoint nine members to the committee in
a manner that ensures that the committee meets certain criteria. 

  (f)  Requires the committee to elect officers from among the committee
members. 

(g)  Requires appointments to the committee be made without regard to
certain  characteristics of the appointees. 

(h)  Prohibits a member of the committee from receiving compensation, but
entitles a member to reimbursement of travel expenses incurred by the
member while conducting the business of the committee as provided by the
General Appropriations Act. 

(i)  Requires the commission to provide administrative support and
resources to the committee as necessary for the committee to perform the
duties under this section. 

(j)  Provides that the committee is not subject to Chapter 2110.

(k)  Requires the commission, with advice from the committee, to ensure
that certain conditions occur. 

(l)  Requires the commission, for the purposes of Subsection (k), to
exclude data from the Texas-Mexico border region in determining certain
information. 

(m)  Authorizes the commission, with advice from the committee and other
appropriate groups, to vary the amount of any rate increases for services
required by Subsection (k) according to the type of service provided. 

(n)  Requires the commission to develop mechanisms to pass any rate
increase required by Subsection (k) directly to providers, including
providers in Medicaid managed care service delivery areas with health
maintenance organization, prepaid health plan, or primary care case
management models. 

(o)  Requires the commission to contract with a public university to ensure
certain tasks and duties are completed. 

  (p)  Provides that this section expires September 1, 2011.

SECTION 2.  Requires a state agency that determines, before implementing
any provision of this Act, that a waiver or authorization from a federal
agency is necessary for implementation of that provision to request the
waiver or authorization, and authorizes the agency to delay implementing
that provision until the waiver or authorization is granted. 

SECTION 3.  (a)  Requires that the changes in rates and expenditures
required by Section 531.0221(k), Government Code, as added by this Act, be
initiated not later than September 1, 2002. 

(b)  Requires the advisory committee on funding disparities in health
programs to deliver the first report required by Section 531.0221(c),
Government Code, as added by this Act, not later than January 1, 2002. 

SECTION 4.  Effective date: September 1, 2001.

SUMMARY OF COMMITTEE CHANGES

Amends As Filed S.B. 1053 by amending the section title to Section
531.0221, Government Code. Amends proposed text pertaining to the areas for
which the advisory committee is required to develop a strategic plan.
Removes and adds proposed text pertaining to conditions the commission must
ensure occur.  Removes proposed text pertaining to professional
expenditures and services.  Adds proposed text pertaining to the items for
which the commission must contract with a public university.  Requires the
report required by Section 531.0221(c), Government Code, as added by this
Act, to be delivered not later than January 1, 2002, rather than September
1, 2002.  Makes conforming changes.