By: Lucio, Shapleigh S.B. No. 1299
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the creation and duties of a task force on rate-setting
1-3 methodologies for the Medicaid and state child health plan
1-4 programs.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subchapter B, Chapter 531, Government Code, is
1-7 amended by adding Section 531.0221 to read as follows:
1-8 Sec. 531.0221. TASK FORCE ON RATE-SETTING METHODOLOGIES FOR
1-9 MEDICAID PROGRAM AND STATE CHILD HEALTH PLAN PROGRAM. (a) In this
1-10 section:
1-11 (1) "Child health plan program" means the state child
1-12 health plan program authorized by Chapter 62, Health and Safety
1-13 Code.
1-14 (2) "Health care provider" means a hospital, long-term
1-15 care facility, physician, dentist, emergency medical services
1-16 provider, or other provider of services eligible for reimbursement
1-17 under the Medicaid or child health plan program.
1-18 (3) "Task force" means the task force on rate-setting
1-19 methodologies for the Medicaid and child health plan programs
1-20 appointed by the commissioner under this section.
1-21 (b) The commissioner shall appoint a task force to examine
1-22 and evaluate rate-setting methodologies for the Medicaid program
1-23 and the child health plan program.
1-24 (c) The commissioner shall appoint 11 members to serve on
1-25 the task force. The task force shall be composed of:
2-1 (1) representatives of the Texas Department of Health
2-2 who are involved in the administration of the Medicaid program or
2-3 the child health plan program;
2-4 (2) health economists active in the area of public
2-5 health research who are associated with an academic institution;
2-6 (3) public health professionals, including at least
2-7 one epidemiologist; and
2-8 (4) health care providers or their representatives.
2-9 (d) A member of the task force may not receive compensation
2-10 but is entitled to reimbursement of travel expenses incurred by
2-11 the member while conducting the business of the task force as
2-12 provided by the General Appropriations Act.
2-13 (e) The commission shall provide administrative support and
2-14 resources to the task force as necessary for the task force to
2-15 perform the duties under this section.
2-16 (f) The task force is not subject to Chapter 2110.
2-17 (g) The task force shall perform the research necessary to
2-18 evaluate the rate-setting methodologies for the Medicaid program
2-19 and the child health plan program and, not later than December 1,
2-20 2002, produce a report based on the results of that evaluation.
2-21 The report must include recommendations of the task force on ways
2-22 to improve the rate-setting methodologies.
2-23 (h) The task force shall, in preparing the report required
2-24 under Subsection (g), examine relevant information including:
2-25 (1) the incidence and prevalence of disease in
2-26 comparison to the utilization of services;
3-1 (2) the number of health care providers participating
3-2 in the Medicaid program and the child health plan program who are
3-3 providing services in the various geographic areas of the state;
3-4 (3) the number of people eligible for the Medicaid
3-5 program and the child health plan program;
3-6 (4) the potential effects of developing incentive
3-7 programs such as rate increases targeted to encourage health care
3-8 providers to relocate or remain in underserved areas;
3-9 (5) the potential effects of developing a tiered
3-10 system of rate increases based on level of need;
3-11 (6) the expenditures in Texas under the Medicaid
3-12 program and the child health plan program, compared to comparable
3-13 national averages and the averages of the top 15 industrial states
3-14 as ranked by the United States Department of Commerce Bureau of
3-15 Economic Analysis, based on gross state product; and
3-16 (7) any other significant factors relating to
3-17 rate-setting methodologies.
3-18 (i) The task force shall seek technical assistance, if
3-19 needed, from representatives of the federal Health Care Financing
3-20 Administration.
3-21 (j) The task force shall deliver the report required under
3-22 Subsection (g) to the commissioner and to the legislature.
3-23 (k) The task force shall:
3-24 (1) continue to monitor the information evaluated in
3-25 the report required under Subsection (g) and any changes made in
3-26 the rate-setting methodologies for the Medicaid program and the
4-1 child health plan program; and
4-2 (2) submit another report with any additional
4-3 recommendations to the commissioner and the legislature not later
4-4 than December 1, 2004.
4-5 (l) This section expires September 1, 2005.
4-6 SECTION 2. This Act takes effect September 1, 2001.
4-7 COMMITTEE AMENDMENT NO. 1
4-8 Amend S.B. 1299 as follows:
4-9 (1) On page 2, line 8, strike "." and replace with ", and"
4-10 (2) On page 2, line 8, insert "(5) representatives of one
4-11 or more health maintenance organizations that arrange health care
4-12 services for members in Medicaid managed care or the child health
4-13 plan program or both, so long as experience in both Medicaid
4-14 managed care and the child health plan program is represented on
4-15 the task force." and (6) one or more public representative.
4-16 and renumber thereafter.
4-17 Coleman