HBA-LJP S.B. 1299 77(R)    BILL ANALYSIS


Office of House Bill AnalysisS.B. 1299
By: Lucio
Public Health
5/17/2001
Committee Report (Amended)



BACKGROUND AND PURPOSE 

Current Medicaid and child health plan program (CHIP) reimbursement rates
are often below the cost of providing services.  Some providers place a
limit on the number of Medicaid or CHIP patients the providers accept based
on the number of estimated private pay patients to offset the financial
loss incurred by the low Medicaid and CHIP reimbursement rates.  However,
in areas with a disproportionately high number of Medicaid and CHIP
patients, providers may be unable to offset the financial loss.  Also, the
method of determining reimbursement rates often fails to take into account
such things as the adverse effects of low cost structures in certain areas
and issues of inadequate access to care.  Senate Bill 1299 establishes a
task force to examine and evaluate rate-setting methodologies for the
Medicaid and CHIP program. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

ANALYSIS

Senate Bill 1299 amends the Government Code to require 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 (CHIP).  The bill requires the task force to
produce a report no later than December 1, 2002, based on the results of
the evaluation and deliver the report to the commissioner and the
legislature.  The report must include recommendations on ways to improve
the ratesetting methodologies.  The bill sets forth the relevant
information that the task force is to consider in preparing the report.
The bill requires the task force to continue to monitor the information
evaluated in the report and any changes made in the rate-setting
methodologies for the Medicaid and CHIP programs and to submit another
report with any additional recommendations to the commissioner and the
legislature not later than December 1, 2004. 

The bill sets forth the composition, compensation, and the reimbursement of
the 11 member task force. The bill requires the Health and Human Services
Commission to provide administrative support and resources to the task
force as necessary and provides that the task force is not subject to
provisions relating to state advisory committees.  The bill requires the
task force to seek technical assistance, if needed, from the federal Health
Care Financing Administration. 

The provisions of this bill expire September 1, 2005.

EFFECTIVE DATE

September 1, 2001.

EXPLANATION OF AMENDMENTS

Committee Amendment No. 1 adds to the composition of the task force
representatives of one or more  health maintenance organizations that
arrange health care services for members in Medicaid managed care, the
child health plan program (CHIP), or both and provides that experience in
both Medicaid managed care and CHIP be represented on the task force.  The
amendment also adds one or more public representatives to the task force.