C.S.H.B. 3485 78(R)    BILL ANALYSIS


C.S.H.B. 3485
By: Delisi
State Health Care Expenditures, Select
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

The Department of Human Services' regulations state that non-emergency
transportation costs are to be covered in the rates paid for Medicaid
nursing home patients. However, the Health and Human Services Commission
has not used these costs as a factor in its rate analysis for nursing
homes. The stipulation in state regulations calling for these services to
be included in the nursing home rate has led the Texas Department of
Health's (TDH) transportation program to not provide medically necessary
non-emergency transportation for clients in nursing homes. 

Consequently, many nursing homes use ambulance services to transport their
renal dialyses clients even when they do not need special transportation.
Costs for ambulance service are considerably higher than those of the
Medical Transportation Program. 

This bill would require TDH  rule changes to allow the use of Medical
Transportation Program funds for nursing-home clients to reduce the cost
of meeting their transportation needs. 

RULEMAKING AUTHORITY

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

ANALYSIS

C.S.H.B. 3485 directs that the TDH, in its rules governing the Medical
Transportation Program, may not prohibit a recipient of medical assistance
from receiving transportation services through the program to obtain renal
dialysis treatment on the basis that the recipient resides in a nursing
facility.  

C.S.H.B. 3485 provides that if a state agency determines that a waiver or
authorization is needed from a federal agency then the state agency must
request a waiver or obtain the necessary authorization from the federal
agency.  The implementation date may be delayed until the waiver or
authorization is granted by the federal agency.  
 
EFFECTIVE DATE

This Act takes effect September 1, 2003.

COMPARISON OF ORIGINAL TO SUBSTITUTE

C.S.H.B. 3485 narrows the scope of the H.B. 3485 by inserting "to obtain
renal dialyses treatment" in Section 1, Subsection (t-1). 

C.S.H.B. 3485 amends SECTION 2, by adding language that would delay the
implementation date if approval from a federal agency is needed.