H.B. 1555 78(R)    BILL ANALYSIS


H.B. 1555
By: Coleman
State Health Care Expenditures, Select
Committee Report (Unamended)



BACKGROUND AND PURPOSE 

Until recently, individuals diagnosed with schizophrenia or bipolar
disorder were prescribed medications that caused severe side effects.
Because of these side effects, individuals often discontinued medications,
relapsed, and ended up in high-cost institutional care. In the mid 1990s
pharmaceutical manufacturers developed a new generation of medications to
treat schizophrenia called atypical antipsychotics, which were found to be
highly effective with significantly fewer side effects. The new generation
of drugs can cost about $4,000 per person per year or more. If an
individual cannot afford treatment, they often debilitate physically, to
the point that the individual would qualify for disability related
Medicaid, which costs the state about $15,000 per person per year.
Therefore, investing in new generation medications and support services is
clearly cost effective. The Texas Department of Mental Health and Mental
Retardation, as one of its performance goals, is conducting a study on the
number of persons receiving psychotropic medication for programmatic or
emergency use. House Bill 1555 authorizes a demonstration project to offer
such medications and requires the Health and Human Services Commission to
report on the costeffectiveness of the use of the new generation of drugs. 

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any
additional rulemaking authority to a state officer, department, agency, or
institution. 

ANALYSIS

House Bill 1555 amends the Human Resources Code to require the Health and
Human Services Commission (HHSC) to establish a demonstration project to
provide to eligible persons through the medical assistance program
pscyhotropic medications and related laboratory and physician services
necessary to conform to a prescribed medical regime for those medications.
The bill sets forth eligibility requirements for participation in the
demonstration project and provides that participants are not subject to
the monthly three-prescription limit under the medical assistance program.
The bill requires HHSC to submit a biennial report to the legislature
regarding the demonstration project's progress and operation no later than
December 1 of each even numbered year. The bill requires HHSC to evaluate,
no later than December 1, 2008, the cost-effectiveness of the
demonstration project, including whether the preventive drug treatments
and related services provided under the project offset future long-term
care costs for project participants. If the results of the evaluation
indicate that the project is cost-effective, the bill requires HHSC to
incorporate a request for funding for the continuation of the program in
its budget request for the next state fiscal biennium. The bill provides
that the demonstration project expires September 1, 2011.  

EFFECTIVE DATE

This Act takes effect immediately if it receives a vote of two-thirds of
all the members of each house, as provided by Section 39, Article III,
Texas Constitution.  If the Act does not receive the necessary vote for
immediate effect, this Act takes effect September 1, 2003.