SRC-MKV S.B. 1299 77(R)BILL ANALYSIS


Senate Research CenterS.B. 1299
By: Lucio
Health & Human Services
6/11/2001
Enrolled

DIGEST AND PURPOSE 

Current Medicaid and CHIP reimbursement rates are substantially below the
cost of providing services. As a result, some providers compensate for the
differential by placing a quota on how many Medicaid and/or CHIP patients
they will accept based on the number of private pay patients they
anticipate, thereby offsetting the financial loss incurred by the low
Medicaid/CHIP reimbursement rates.  In those areas with disproportionately
high numbers of Medicaid and CHIP patients, this balancing of costs
tradeoff is not an option.  Furthermore, the method of determining
reimbursement rates, although intended to reflect local costs and
utilization, fails to take into account such things as the adverse effects
of low cost structures in certain areas and the many aspects of inadequate
access to care.  S.B. 1299 requires the creation of a task force with
multi-disciplined participation by professionals with varied resources and
areas of expertise.  The task force is charged with comprehensively
evaluating reimbursement rates statewide including, but not limited to,
specific considerations enumerated in the language of the bill, and
developing recommendations for change. 

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.  TASK FORCE ON RATE-SETTING METHODOLOGIES FOR MEDICAID
PROGRAM AND STATE CHILD HEALTH PLAN PROGRAM. (a)  Defines  "child health
plan program,"  "health care provider," and "task force." 
 
(b)  Requires the commissioner of health and human services (commissioner)
to appoint a task force to examine and evaluate rate-setting methodologies
for the Medicaid program and the child health plan program. 
 
(c)  Requires the commissioner to appoint 11 members to serve on the task
force.  Sets forth the composition of the task force. 
 
(d)  Prohibits a member of the task force from receiving compensation, but
entitles the member to reimbursement of travel expenses incurred by the
member while conducting the business of the task force as provided by the
General Appropriations Act. 
 
(e)  Requires the Health and Human Services Commission (commission) to
provide administrative support and resources to the task force as necessary
for the task force to perform the duties under this section. 
 
(f)  Provides that the task force is not subject to Chapter 2110 (State
Agency Advisory Committees), Government Code. 
 
 (g)  Requires the task force to perform the research necessary to evaluate
the rate-setting methodologies for the Medicaid program and the child
health plan program and, not later than December 1, 2002, produce a report
based on the results of that evaluation.  Requires the report to include
recommendations of the task force on ways to improve the rate-setting
methodologies. 
 
(h)  Requires the task force, in preparing the report required under
Subsection (g), to examine certain relevant information. 
  
(i)  Requires the task force to seek technical assistance if needed from
representatives of the federal Health Care Financing Administration. 
 
(j)  Requires the task force to deliver the report required under
Subsection (g) to the commissioner and to the legislature. 
 
  (k)  Requires the task force to carry out certain duties.
  
  (l)  Provides that this section expires September 1, 2005.
 
SECTION 2. Effective date: September 1, 2001.