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