SRC-MSY S.B. 327 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 327
78R1387 KEG-DBy: Janek
Health & Human Services
2/19/2003
As Filed


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. As
proposed, S.B. 327 requires the Health and Human Services Commission 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 in SECTION 1 (Section  32.059, Human Resources Code) of this
bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 32B, 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 (HHS) to request contract
proposals from providers of disease management programs to provide program
services to medical care recipients who have certain diseases or other
chronic health conditions that HHS determines need disease management, and
who are not eligible to receive those services under a Medicaid managed
care plan. 

(b)  Requires HHS to specifically request proposals to provide disease
management program services for pregnant women and children who reside in
the Rio Grande Valley who are recipients of medical assistance, receive
treatments of asthma-related health conditions, and who are not eligible
to receive those services under a Medicaid managed care plan. 

(c)  Authorizes HHS to contract with a private entity to perform certain
tasks relating to the implementation of this section. 

(d)  Requires HHS 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. 

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

SECTION 2.  (a) Requires HHS 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
include certain information. 

(b)  Requires HHS to consider results of the study when requesting
contract proposals under Section 32.059, as added by this Act. 

(c)  Authorizes HHS to contract with a private entity to conduct a study
and produce a report under this section. 

(d)  Requires HHS 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.