81R7144 ALB-D

By: Watson S.B. No. 1513

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.