87R1834 JG-D
 
  By: Blanco S.B. No. 171
 
 
 
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 under Medicaid.
  The commission shall collaborate with the medical care advisory
  committee established under Section 32.022, Human Resources Code,
  to develop and define the scope of the research for the report. The
  report must:
               (1)  review the provider reimbursement rates for at
  least 20 Medicaid-covered services;
               (2)  outline factors of the reimbursement rate
  methodologies used by Medicaid managed care organizations;
               (3)  propose alternative reimbursement methodologies;
               (4)  evaluate the impact of Medicaid provider
  reimbursement rates on access to care for Medicaid recipients;
               (5)  compare provider participation in Medicaid by
  region, particularly increases or decreases in the number of
  participating providers per year beginning with the state fiscal
  year ending August 31, 2012, categorized by provider specialty and
  subspecialty;
               (6)  list to the extent the information is available,
  for each state fiscal quarter beginning with the first quarter of
  the state fiscal year ending August 31, 2017:
                     (A)  counties in which provider access standards
  relating to distance have not been met; and
                     (B)  counties in which provider access standards
  relating to travel time have not been met;
               (7)  examine Medicaid directed provider payments and
  their effect on incentivizing providers to participate or continue
  participating in Medicaid, including:
                     (A)  the uniform hospital rate increase program
  described by 1 T.A.C. Section 353.1305;
                     (B)  the quality incentive payment program
  (QIPP); and
                     (C)  the minimum reimbursement rate for nursing
  facilities described by Section 533.00251, Government Code; 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, 2022, 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, 2021.