By: Rodríguez S.B. No. 2040
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a report regarding Medicaid reimbursement rates and
  access to care.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  (a)  In this section, "commission" means the
  Health and Human Services Commission.
         (b)  The commission shall prepare a written report regarding
  provider reimbursement rates and access to care in the Medicaid
  program.  The report must:
               (1)  outline each factor of the reimbursement rate
  methodology used by Medicaid managed care organizations and that
  factor's weight in the methodology;
               (2)  explicitly illustrate the manner in which the
  following affect current methodologies:
                     (A)  previously adopted reimbursement rates;
                     (B)  the cost of uncompensated care provided to
  uninsured persons; and
                     (C)  use of private insurance benefits;
               (3)  propose alternative reimbursement methodologies
  that do not consider the items described by Subdivision (2) of this
  subsection;
               (4)  evaluate how Medicaid provider reimbursement
  rates affect access to care for Medicaid recipients, measured by
  the number of providers each year who have stopped participating in
  Medicaid since the commission began offering Medicaid services
  through a managed care delivery model;
               (5)  compare provider participation in Medicaid by
  region, particularly increases or decreases in the number of
  participating providers since the commission began offering
  Medicaid services through a managed care delivery model,
  categorized by provider specialty and subspecialty;
               (6)  list, for each year since the commission began
  offering Medicaid services through a managed care delivery model,
  counties in which provider access standards have not been met;
               (7)  examine Medicaid provider incentive payment
  programs and their effect on incentivizing providers to participate
  or continue participating in Medicaid; and
               (8)  determine the feasibility and cost of
  establishing:
                     (A)  a minimum fee schedule for Medicaid providers
  in counties where provider access standards are not being met; and
                     (B)  a different reimbursement rate for classes of
  providers who provide care in a county:
                           (i)  located on an international border; or
                           (ii)  with a Medicaid population at least 10
  percent higher than the statewide average Medicaid population.
         (c)  Not later than December 1, 2020, the commission shall
  prepare and submit to the legislature the report described by
  Subsection (b) of this section.  Notwithstanding that subsection,
  the commission is not required to include in the report any
  information the commission determines is proprietary.
         SECTION 2.  This Act takes effect September 1, 2019.