By Nelson                                               S.B. No. 99
         77R989 KKA-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to an evaluation of preauthorization requirements imposed
 1-3     by managed care organizations providing health care services to
 1-4     recipients of medical assistance.
 1-5           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-6           SECTION 1. Subchapter A, Chapter 533, Government Code, is
 1-7     amended by adding Section 533.016 to read as follows:
 1-8           Sec. 533.016.  EVALUATION OF PREAUTHORIZATION REQUIREMENTS.
 1-9     (a)  The commission, in cooperation with the Texas Department of
1-10     Insurance, shall:
1-11                 (1)  evaluate the effectiveness of requiring managed
1-12     care organizations providing health care services to recipients to
1-13     eliminate preauthorization requirements for routine health care
1-14     services that are customarily approved by the managed care
1-15     organizations;
1-16                 (2)  develop proposed procedures for:
1-17                       (A)  identifying routine health care services for
1-18     which preauthorization requirements should be eliminated; and
1-19                       (B)  ensuring that health care providers receive
1-20     notice of health care services for which preauthorization is
1-21     required;
1-22                 (3)  develop a proposed standard preauthorization form
1-23     to be used by managed care organizations providing health care
1-24     services to recipients; and
 2-1                 (4)  submit a report to the legislature regarding the
 2-2     evaluation, proposed procedures, and proposed standard
 2-3     preauthorization form.
 2-4           (b)  This section expires September 1, 2003.
 2-5           SECTION 2. The Health and Human Services Commission shall
 2-6     submit the report required by Section 533.016, Government Code, as
 2-7     added by this Act, not later than November 1, 2002.
 2-8           SECTION 3. This Act takes effect immediately if it receives a
 2-9     vote of two-thirds of all the members elected to each house, as
2-10     provided by Section 39, Article III, Texas Constitution.  If this
2-11     Act does not receive the vote necessary for immediate effect, this
2-12     Act takes effect September 1, 2001.