Honorable Richard Peña Raymond, Chair, House Committee on Human Services
FROM:
Ursula Parks, Director, Legislative Budget Board
IN RE:
HB2731 by Raymond (Relating to decreasing administrative burdens of Medicaid managed care for the state, the managed care organizations, and providers under managed care networks.), Committee Report 1st House, Substituted
There could be significant costs related to implementing the provisions of the bill, but because needed system modifications at managed care organizations are unknown, the fiscal impact to the state cannot be determined.
The bill would amend requirements related to administration of Medicaid managed care contracts to decrease administrative burdens for the state, managed care organizations (MCOs), and providers enrolled in managed care networks. According to the Health and Human Services Commission (HHSC), the cost to implement most provisions in the bill would be minimal and could be absorbed within available resources. HHSC indicates current contracts require MCOs to offer providers the option of submitting and receiving claims information through an electronic data exchange. However, contracts would need to be amended to include the requirement that the data portal accept all necessary attachments and to accept corrected or additional documentation. Certain MCOs may need to modify systems, which could impact the administrative rate HHSC pays to those plans. There could be significant costs related to implementing the provisions of the bill related to electronic submission and obtaining information electronically, but because needed system modifications at MCOs are unknown, the fiscal impact to the state cannot be determined.
Local Government Impact
No fiscal implication to units of local government is anticipated.