By Kitchen                                            H.B. No. 3386
         Line and page numbers may not match official copy.
         Bill not drafted by TLC or Senate E&E.
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to implementation of Medicaid managed care pilot programs.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1. Section 533.012, Government Code, is amended to
 1-5     read as follows:
 1-6           Sec. 533.012.  [MORATORIUM ON] IMPLEMENTATION OF CERTAIN
 1-7     PILOT PROGRAMS[; REVIEW; REPORT]. (a)  Notwithstanding any other
 1-8     law, the commission shall [may not] implement Medicaid managed care
 1-9     pilot programs[, Medicaid behavioral health pilot programs, or
1-10     Medicaid Star + Plus pilot programs] in [a] regions [for] in which
1-11     the commission [has not] is not currently operating a pilot program
1-12     unless the commission determines that implementation of such a
1-13     program would not be feasible or beneficial in a particular
1-14     region.[:]
1-15                 [(1)  received a bid from a managed care organization
1-16     to provide health care services to recipients in the region through
1-17     a managed care plan; or]
1-18                 [(2)  entered into a contract with a managed care
1-19     organization to provide health care services to recipients in the
1-20     region through a managed care plan.]
1-21           [(b)  The commission shall:]
1-22                 [(1)  review any outstanding administrative and
1-23     financial issues with respect to Medicaid managed care pilot
 2-1     programs, Medicaid behavioral health pilot programs, and Medicaid
 2-2     Star + Plus pilot programs implemented in health care service
 2-3     regions;]
 2-4                 [(2)  review the impact of the Medicaid managed care
 2-5     delivery system, including managed care organizations, prepaid
 2-6     health plans, and primary care case management, on:]
 2-7                       [(A)  physical access and program-related access
 2-8     to appropriate services by recipients, including recipients who
 2-9     have special health care needs;]
2-10                       [(B)  quality of health care delivery and patient
2-11     outcomes;]
2-12                       [(C)  utilization patterns of recipients;]
2-13                       [(D)  statewide Medicaid costs;]
2-14                       [(E)  coordination of care and care coordination
2-15     in Medicaid Star + Plus pilot programs;]
2-16                       [(F)  the level of administrative complexity for
2-17     providers, recipients, and managed care organizations;]
2-18                       [(G)  public hospitals, medical schools, and
2-19     other traditional providers of indigent health care; and]
2-20                       [(H)  competition in the marketplace and network
2-21     retention; and]
2-22                 [(3)  evaluate the feasibility of developing a separate
2-23     reimbursement methodology for public hospitals under a Medicaid
2-24     managed care delivery system.]
2-25           [(c)  In performing its duties and functions under Subsection
2-26     (b), the commission shall seek input from the state Medicaid
 3-1     managed care advisory committee created under Subchapter C.  The
 3-2     commission may coordinate the review required under Subsection (b)
 3-3     with any other study or review the commission is required to
 3-4     complete.]
 3-5           [(d)  Notwithstanding Subsection (a), the commission may
 3-6     implement Medicaid managed care pilot programs, Medicaid behavioral
 3-7     health pilot programs, and Medicaid Star + Plus pilot programs in a
 3-8     region described by that subsection if the commission finds that:]
 3-9                 [(1)  outstanding administrative and financial issues
3-10     with respect to the implementation of those programs in health care
3-11     service regions have been resolved; and]
3-12                 [(2)  implementation of those programs in a region
3-13     described by Subsection (a) would benefit both recipients and
3-14     providers.]
3-15           [(e)  Not later than November 1, 2000, the commission shall
3-16     submit a report to the governor and the legislature that:]
3-17                 [(1)  states whether the outstanding administrative and
3-18     financial issues with respect to the pilot programs described by
3-19     Subsection (b)(1) have been sufficiently resolved;]
3-20                 [(2)  summarizes the findings of the review conducted
3-21     under Subsection (b);]
3-22                 [(3)  recommends which elements of the Medicaid managed
3-23     care delivery system should be applied to the traditional
3-24     fee-for-service component of the state Medicaid program to achieve
3-25     the goals specified in Section 533.002(1); and]
3-26                 [(4)  recommends whether Medicaid managed care pilot
 4-1     programs, Medicaid behavioral health pilot programs, or Medicaid
 4-2     Star + Plus pilot programs should be implemented in health care
 4-3     service regions described by Subsection (a).]
 4-4           [(f)  To the extent practicable, this section may not be
 4-5     construed to affect the duty of the commission to plan the
 4-6     continued expansion of Medicaid managed care pilot programs,
 4-7     Medicaid behavioral health pilot programs, and Medicaid Star + Plus
 4-8     pilot programs in health care service regions described by
 4-9     Subsection (a) after July 1, 2001.]
4-10           [(g)  Notwithstanding any other law, the commission may not
4-11     use federal medical assistance funds to implement any long-term
4-12     care integrated network pilot studies.]
4-13           [(h)  This section expires July 1, 2001.]
4-14           SECTION 2.  If before implementing any provision of this Act
4-15     a state agency determines that a waiver or authorization from a
4-16     federal agency is necessary for implementation of that provision,
4-17     the agency affected by the provision shall request the waiver or
4-18     authorization and may delay implementing that provision until the
4-19     waiver or authorization is granted.
4-20           SECTION 3.  This Act takes effect immediately if it receives
4-21     a vote of two-thirds of all members elected to each house, as
4-22     provided by Section 29, Article III, Texas Constitution.  If this
4-23     Act does not receive the vote necessary for immediate effect, this
4-24     Act takes effect September 1, 2001.