SRC-MLC S.B. 398 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 398
78R2004 KEG-DBy: Shapleigh
Health & Human Services
2/14/2003
As Filed


DIGEST AND PURPOSE 

Currently, in some rural areas in Texas and areas near the Texas-Mexico
border, Medicaid and Children's Health Insurance Program (CHIP)
reimbursement rates are lower than rates elsewhere in the state.  As
proposed, S.B. 398 increases the Medicaid and CHIP reimbursement rates in
strategic investment areas to the statewide average.  S.B. 398 provides
that the Health and Human Services Commission (HHS) will calculate the
statewide average reimbursement rates and requires HHS to make such rates
equitable throughout the state.   

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to
a state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 531B, Government Code, by adding Section
531.0224, as follows: 

Sec. 531.0224.  RATES AND EXPENDITURES IN CERTAIN STRATEGIC INVESTMENT
AREAS.  (a)  Defines "child health plan program" and "strategic investment
area." 

(b)  Requires the Health and Human Services Commission (HHS) to ensure in
each strategic investment area: that the capitation rates under the
Medicaid managed care program and the child health plan program are not
less than their respective statewideaverage capitation rates; that the
fee-for-service reimbursement rates for inpatient and outpatient hospital
services under these two programs are not less than their respective
statewide-average fee-for-service reimbursement rates; and that the total
professional services expenditures per Medicaid recipient and per child
health plan program enrollee are not less than their respective statewide
average expenditures. 
        
(c)  Requires HHS, for purposes of Subsection (b), to exclude data from
strategic investment areas in determining the statewide averages for
capitation rates, fee-forservice reimbursement rates, and professional
services expenditures.   

SECTION 2.  Requires the changes in rates and expenditures required by
Section 531.0224, Government Code, to be implemented on or by September 1,
2004.   

SECTION 3.  Requires a state agency that needs a waiver or authorization
from a federal agency in order to implement any provision of this Act to
request the waiver or authorization; and authorizes the affected agency to
delay the implementation of the particular provision until the waiver or
authorization is granted. 

SECTION 4.  Effective date:  September 1, 2003.