Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM:
John McGeady, Assistant Director Sarah Keyton, Assistant Director Legislative Budget Board
IN RE:
SB1235 by Buckingham (Relating to the enrollment of health care providers in Medicaid.), As Introduced
The fiscal implications of the bill related to changes to provider enrollment in the Medicaid program cannot be determined at this time.
The bill would amend Chapter 531 of the Government Code to allow providers that are credentialed by a managed care organization (MCO) or enrolled in Medicare to participate in Medicaid without also enrolling with the states Medicaid claims administrator. The Health and Human Services Commission indicates that allowing providers to participate in Medicaid without following Medicaid enrollment requirements would require federal approval of a waiver, as well as significant changes to the provider management and enrollment system (PMES) of the state Medicaid Management Information System (MMIS). Based on LBB analysis of average implementation costs for change order requests to the MMIS, LBB estimates that implementation costs for changes relating to the provisions of the bill could have a General Revenue impact of up to $2.4 million in All Funds ($1.2 million in General Revenue). However, costs for changes related to the PMES could vary significantly based on the exact changes required.
The bill would take effect September 1, 2019.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.