LEGISLATIVE BUDGET BOARD

Austin, Texas

FISCAL NOTE, 80TH LEGISLATIVE REGULAR SESSION

March 27, 2007

TO:	Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
FROM:	John S. O'Brien, Director, Legislative Budget Board
IN RE:	SB569 by Deuell (Relating to reimbursement for health care services provided at certain times to persons enrolled in the Medicaid managed care program.), As Introduced

No significant fiscal implication to the State is anticipated.

The bill would amend Chapter 533 of the Government Code to add Sec. 533.01315, Reimbursement for Services Provided Outside of Regular Business Hours.

The bill would require that a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) be reimbursed for health care services provided to a Medicaid client, regardless of whether the client has a referral from his/her primary care physician (PCP), when the services are provided outside of regular business hours.

The bill would direct HHSC to seek federal authority or a waiver if required, and allows for delay of implementation until such authority or waiver is granted.

The bill would take effect on September 1, 2007.

The Health and Human Services Commission does not have sufficient information to provide a cost estimate at this time; however, it is likely there would be both additional costs for reimbursing providers for after-hours care, as well as savings from the provision of less hospital-based care, which tends to be more expensive than clinic-based services.

Local Government Impact

HHSC estimates that local governments which operate clinics may collect higher revenues from increased provider payments for after-hours care.

Source Agencies:

529 Health and Human Services Commission

LBB Staff:

JOB, CL, PP, MB