SRC-VRA H.B. 727 78(R)    BILL ANALYSIS


Senate Research CenterH.B. 727
By: Delisi (Janek)
Health & Human Services
5/4/2003
Engrossed

DIGEST AND PURPOSE 

Current Texas law does not provide programs for Medicaid-ineligible
individuals with chronic diseases or conditions with assistance to help
them better understand and manage their conditions.  Such disease
management programs aim to lower state costs and increase recipients'
quality of health by reducing hospital and emergency room visits.  H.B.
727 requires the Health and Human Services Commission or an agency
operating a part of the medical assistance program as appropriate, to
request contract proposals from disease management program providers and
to conduct research on the potential for state savings through the use of
such programs. 

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the Health and Human Services
Commission or an agency operating prat of the medical assistance program
as appropriate, in SECTION 1 (Section 32.059, Human Resources Code) of
this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 32.059, as follows: 

Sec.  32.059.  CONTRACTS FOR DISEASE MANAGEMENT PROGRAMS.  (a) Requires
the Health and Human Services Commission or an agency operating prat of
the medical assistance program as appropriate (department) to request
contract proposals from providers of disease management programs to
provide program services to recipients of medical assistance who have
certain diseases or other chronic health conditions that the department
determines need disease management, and who are not eligible to receive
those services under a Medicaid managed care plan. 

(b)  Authorizes the department to contract with a public or private entity
to perform certain tasks.  

(c)  Requires the department to prescribe, by rule, the minimum
requirements that a provider of a disease management program must meet in
order to be eligible to receive a contract under this section.  Requires
the provider, at a minimum, to perform certain tasks.  

(d)  Prohibits the department from awarding a contract for a disease
management program under this section unless the contract includes a
written guarantee of state savings on expenditures for the group of
medical assistance recipients covered by the program.  

SECTION 2.  (a) Requires the Health and Human Services Commission (HHSC)
to conduct a study to analyze the potential for state savings through the
use of programs under Section 32.059, Human Resources Code, as added by
this Act.  Specifies that the study must identify certain health
conditions. 

(b)  Requires HHSC to consider results of the study when requesting
contract proposals under Section 32.059, as added by this Act. 
 
(c)  Authorizes HHSC to contract with a private entity to conduct a study
and produce a report under this section. 

(d)  Requires HHSC to complete the study required by this section by
December 31, 2003. 

SECTION 3.  Authorizes an agency to delay implementation of any provision
of this act while requesting a waiver or authorization from a federal
agency, if the agency determines that such a waiver is necessary for
implementation of that provision. 

SECTION 4.  Effective date:  September 1, 2003.