BILL ANALYSIS

C.S.H.B. 3541

By: Price

Public Health

Committee Report (Substituted)

BACKGROUND AND PURPOSE

Interested parties suggest that patients would benefit from the increased integration of physical and behavioral health services. C.S.H.B. 3541 seeks to address this issue by changing the requirements for Medicaid managed care organizations that provide behavioral health services through a third party or subsidiary.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 3541 amends the Government Code to require the Health and Human Services Commission (HHSC), for a managed care organization that contracts with HHSC under the Medicaid managed care program and that provides behavioral health services through a contract with a third party or an arrangement with a subsidiary of the managed care organization, to require the effective sharing and integration of care coordination, service authorization, and utilization management data between the managed care organization and the third party or subsidiary; to encourage, to the extent feasible, the colocation of physical health and behavioral health care coordination staff; to require warm call transfers between physical health and behavioral health care coordination staff; to require the managed care organization and the third party or subsidiary to implement joint rounds for physical health and behavioral health services network providers or some other effective means for sharing clinical information; and to ensure that the managed care organization makes available a seamless provider portal for both physical health and behavioral health services network providers, to the extent allowed by federal law. 

EFFECTIVE DATE

September 1, 2017.

COMPARISON OF ORIGINAL AND SUBSTITUTE

While C.S.H.B. 3541 may differ from the original in minor or nonsubstantive ways, the following comparison is organized and formatted in a manner that indicates the substantial differences between the introduced and committee substitute versions of the bill.

INTRODUCED	HOUSE COMMITTEE SUBSTITUTE
SECTION 1.  Subchapter A, Chapter 533, Government Code, is amended by adding Section 533.002553 to read as follows: Sec. 533.002553.  BEHAVIORAL HEALTH SERVICES PROVIDED THROUGH THIRD PARTY OR SUBSIDIARY.  (a)  In this section, "behavioral health services" has the meaning assigned by Section 533.00255. (b)  For a managed care organization that contracts with the commission under this chapter and that provides behavioral health services through a contract with a third party or an arrangement with a subsidiary of the managed care organization, the commission shall: (1)  require the effective sharing and integration of care coordination, service authorization, and utilization management data between the managed care organization and the third party or subsidiary; (2)  encourage, to the extent feasible, the colocation of physical health and behavioral health care coordination staff; (3)  require warm call transfers between physical health and behavioral health care coordination staff; (4)  require the managed care organization and the third party or subsidiary to implement joint rounds for physical health and behavioral health services providers or some other effective means for sharing clinical information; and (5)  ensure that the managed care organization makes available to recipients enrolled in a managed care plan issued by the managed care organization a seamless provider portal for both physical health and behavioral health services providers.	SECTION 1.  Subchapter A, Chapter 533, Government Code, is amended by adding Section 533.002553 to read as follows: Sec. 533.002553.  BEHAVIORAL HEALTH SERVICES PROVIDED THROUGH THIRD PARTY OR SUBSIDIARY.  (a)  In this section, "behavioral health services" has the meaning assigned by Section 533.00255. (b)  For a managed care organization that contracts with the commission under this chapter and that provides behavioral health services through a contract with a third party or an arrangement with a subsidiary of the managed care organization, the commission shall: (1)  require the effective sharing and integration of care coordination, service authorization, and utilization management data between the managed care organization and the third party or subsidiary; (2)  encourage, to the extent feasible, the colocation of physical health and behavioral health care coordination staff; (3)  require warm call transfers between physical health and behavioral health care coordination staff; (4)  require the managed care organization and the third party or subsidiary to implement joint rounds for physical health and behavioral health services network providers or some other effective means for sharing clinical information; and (5)  ensure that the managed care organization makes available a seamless provider portal for both physical health and behavioral health services network providers, to the extent allowed by federal law.
SECTION 2.  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 2. Same as introduced version.
SECTION 3.  This Act takes effect September 1, 2017.	SECTION 3. Same as introduced version.