Honorable Dennis Bonnen, Speaker of the House, House of Representatives
FROM:
John McGeady, Assistant Director Sarah Keyton, Assistant Director Legislative Budget Board
IN RE:
HB4533 by Klick (Relating to the system redesign for delivery of Medicaid acute care services and long-term services and supports to persons with an intellectual or developmental disability or with similar functional needs.), As Passed 2nd House
The fiscal implications of the bill relating to the establishment of a pilot program cannot be determined at this time as the eligibility criteria and benefits to be included in the pilot are unknown. Other administrative costs and costs related to managed care organization accreditation are not anticipated to have a significant fiscal impact in the 2020-21 biennium.
The bill would require the Health and Human Services Commission (HHSC) to collaborate with the Intellectual and Developmental Disability System Redesign Advisory Committee and to establish and collaborate with a pilot program workgroup to develop and implement a Medicaid pilot program to provide long-term services and supports for certain individuals with intellectual or developmental disabilities (IDD) or certain similar functional needs. The pilot would begin on September 1, 2023 and operate for at least two years. The bill would require HHSC to collaborate and consult with the IDD System Redesign Advisory Committee and the pilot program workgroup to perform an evaluation and submit a report after the conclusion of the pilot program. The bill would require HHSC to seek a federal waiver or authorization to provide Medicaid benefits to certain medically fragile individuals if HHSC determines it to be cost-effective. The bill would also require managed care plans offered by a Medicaid managed care organization (MCO) to meet certain accreditation requirements and would require HHSC to prepare and submit a report evaluating the feasibility of providing Medicaid benefits to children enrolled in the STAR Kids managed care program under certain alternative models. The bill would take effect September 1, 2019.
The costs associated with developing and implementing the pilot program cannot be determined at this time, as information is not available to determine the criteria for selecting MCOs to participate in the pilot, the eligibility criteria for the pilot, and the exact benefits included in the pilot. Costs could include significant client services and information technology systems changes that could vary depending on the size and scope of the pilot program. This analysis assumes that any costs associated with implementing the provisions of the bill relating to the pilot program would be immaterial and could be absorbed within existing agency resources for the 2020-21 biennium, but there could be administrative and technology-related costs in the 2022-23 biennium related to implementation of the pilot program on September 1, 2023, or related to the provision of Medicaid benefits to certain medically fragile individuals, if HHSC determines that providing benefits would be cost-effective and receives a federal waiver. Based on the LBB's analysis of HHSC, duties and responsibilities associated with implementing the provisions of the bill related to managed care organization accreditation and other reporting requirements could be absorbed using existing agency resources.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.