By:  Janek                                                        S.B. No. 327
	(In the Senate - Filed January 29, 2003; February 6, 2003, 
read first time and referred to Committee on Health and Human 
Services; March 6, 2003, reported favorably by the following vote:  
Yeas 8, Nays 0; March 6, 2003, sent to printer.)


A BILL TO BE ENTITLED

AN ACT


relating to disease management programs for certain Medicaid 
recipients.  
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter B, Chapter 32, Human Resources Code, 
is amended by adding Section 32.059 to read as follows:
	Sec. 32.059.  CONTRACTS FOR DISEASE MANAGEMENT PROGRAMS.  
(a)  The department shall request contract proposals from 
providers of disease management programs to provide program 
services to recipients of medical assistance who:
		(1)  have a disease or other chronic health condition, 
such as heart disease, diabetes, respiratory illness, end-stage 
renal disease, HIV infection, or AIDS, that the department 
determines is a disease or condition that needs disease management; 
and
		(2)  are not eligible to receive those services under a 
Medicaid managed care plan.
	(b)  The department shall specifically request proposals to 
provide disease management program services for pregnant women and 
children residing in the Rio Grande Valley who are recipients of 
medical assistance, receive treatment of asthma-related health 
conditions, and are not eligible to receive those services under a 
Medicaid managed care plan.
	(c)  The department may contract with a private entity to:              
		(1)  write the requests for proposals;                                 
		(2)  determine how savings will be measured;                           
		(3)  identify populations that need disease 
management; and          
		(4)  develop appropriate contracts.                                    
	(d)  The department, by rule, shall prescribe the minimum 
requirements a provider of a disease management program must meet 
to be eligible to receive a contract under this section.
	(e)  The department may not award 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)  The Health and Human Services Commission 
shall conduct a study to analyze the potential for state savings 
through the use of disease management programs for recipients of 
medical assistance under Section 32.059, Human Resources Code, as 
added by this Act.  The study must identify the diseases and chronic 
health conditions that:
		(1)  result in the highest medical assistance 
expenditures by this state; and
		(2)  show the greatest potential for state savings on 
implementation of disease management programs.
	(b)  The Health and Human Services Commission shall consider 
the results of the study when requesting contract proposals under 
Section 32.059, Human Resources Code, as added by this Act.
	(c)  The Health and Human Services Commission may contract 
with a private entity to  conduct a study and produce a report under 
this section.
	(d)  The Health and Human Services Commission shall complete 
the study required by this section not later than December 31, 2003.
	SECTION 3.  If before implementing any provision of this Act 
a state agency determines that a waiver or authorization from a 
federal agency is necessary for implementation of that provision, 
the agency affected by the provision shall request the waiver or 
authorization and may delay implementing that provision until the 
waiver or authorization is granted.
	SECTION 4.  This Act takes effect September 1, 2003.                           



* * * * *