81R7144 ALB-D
 
  By: Naishtat H.B. No. 1453
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to long-term care consumer information made available
  through the Internet.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 531, Government Code, is
  amended by adding Section 531.0318 to read as follows:
         Sec. 531.0318.  LONG-TERM CARE CONSUMER INFORMATION MADE
  AVAILABLE THROUGH THE INTERNET.  (a)  The Internet site maintained
  under Section 531.0317 must include information for consumers
  concerning long-term care services that complies with this section.  
  The Internet site maintained by the Department of Aging and
  Disability Services must also include, or provide a link to, the
  information required by this section.
         (b)  The information for consumers required by this section
  must:
               (1)  be presented in a manner that is easily accessible
  to, and understandable by, a consumer; and
               (2)  allow a consumer to make informed choices
  concerning long-term care services and include:
                     (A)  an explanation of the manner in which
  long-term care service delivery is administered in different
  counties through different programs operated by the commission and
  by the Department of Aging and Disability Services, so that an
  individual can easily understand the service options available in
  the area in which that individual lives; and
                     (B)  for the Medicaid Star + Plus pilot program,
  information that allows a consumer to evaluate the performance of
  each participating plan issuer, including for each issuer, in an
  accessible format such as a table:
                           (i)  the enrollment in each county;
                           (ii)  additional "value-added" services
  provided;
                           (iii)  the medical loss ratio, together with
  a concise explanation of the meaning of the term in accordance with
  Subsection (c);
                           (iv)  complaint information;
                           (v)  any sanction or penalty imposed by any
  state agency, including a sanction or penalty imposed by the
  commission or the Texas Department of Insurance;
                           (vi)  information concerning consumer
  satisfaction; and
                           (vii)  other data, including relevant data
  from reports of external quality review organizations, that may be
  used by the consumer to evaluate the quality of the services
  provided.
         (c)  For purposes of Subsection (b), "medical loss ratio"
  means direct losses incurred by a participating plan issuer divided
  by direct premiums earned by that issuer as determined under rules
  adopted by the executive commissioner.  The medical loss ratio must
  be updated on a quarterly basis.
         (d)  In addition to providing the information required by
  this section through the Internet, the commission or the Department
  of Aging and Disability Services shall, on request by a consumer
  without Internet access, provide the consumer with a printed copy
  of the information from the website.  The commission or department
  may charge a reasonable fee for printing the information.
         SECTION 2.  (a)  Not later than January 1, 2010, the Health
  and Human Services Commission shall make the information required
  by Section 531.0318, Government Code, as added by this Act,
  available through the Internet.
         (b)  In developing the information required to be made
  available under this Act, the Health and Human Services Commission
  shall incorporate long-term care provider quality information
  reported through the Department of Aging and Disability Services
  Internet site, as well as other appropriate available information
  concerning the quality of services provided through the long-term
  care service delivery programs operated by that department.
         SECTION 3.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2009.