SRC-TBR S.B. 1054 77(R)   BILL ANALYSIS


Senate Research Center   S.B. 1054
77R6489 SGA-DBy: Shapleigh
Health & Human Services
3/20/2001
As Filed


DIGEST AND PURPOSE 

Currently, there is concern that the Medicaid reimbursement and Children's
Health Insurance Program (CHIP) capitation rates in Strategic Investment
Areas are significantly lower than those in other areas of the state.  As
proposed, S.B. 1054 requires the Health and Human Services Commission to
eliminate the rate disparity in strategic investment areas by raising the
Medicaid reimbursement and CHIP capitation rates to a statewide average and
provide for a financial incentive to Medicaid physicians practicing in
strategic investment areas. 

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 STRATEGIC INVESTMENT AREAS. (a)
Defines "child health plan program," "committee," and "strategic investment
area." 

(b)  Requires the Commissioner of Health and Human Services (commissioner)
to appoint an advisory committee to develop a strategic plan for
eliminating the disparities between strategic investment areas and other
areas of the state in certain programs and services. 

(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 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 12 members to the advisory
committee in a manner that ensures that the committee meets certain
requirements. 

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

(g)  Requires appointments to the committee to be made without regard to
the race, color, disability, sex, religion, age, or national origin 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 Health and Human Services Commission (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 (State
Agency Advisory Committees), Government Code. 

(k)  Requires the commission, with advice from the committee, to ensure
that certain requirements are met. 

(l)  Requires the commission, for purposes of Subsection (k), to exclude
data from strategic investment areas in determining the statewide average
capitation rates under Medicaid managed care and the child health plan
program and the statewide average total professional services expenditures
per Medicaid recipient or per child enrolled in the child health plan
program. 

(m)  Authorizes the commission, with advice from the committee and other
appropriate groups, to vary the amount of any rate increases for
professional 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 meet
certain requirements. 

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

SECTION 2.  Requires a state agency, if before implementing any provision
of this Act it determines 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 state agency to delay may delay
implementing that provision until the waiver or authorization is granted. 

SECTION 3.  (a)  Requires the changes in rates and expenditures required by
Section 531.0221(k), Government Code, as added by this Act, to 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 September 1, 2002. 

SECTION 4.  Effective date: September 1, 2001.