Relating to awarding contracts to managed care organizations under Medicaid and the child health plan program.
Impact
If enacted, SB2548 will alter how contracts are awarded by focusing not just on cost but also on the quality of care and organizational capability. This change is expected to enhance the quality of services provided to Medicaid recipients by ensuring that managed care organizations meet specific benchmarks and are held accountable for their performance. The outlined considerations for contract awarding could lead to improved healthcare outcomes for populations traditionally served by these organizations.
Summary
Senate Bill 2548 aims to reform the awarding of contracts to managed care organizations under the Medicaid and child health plan programs. It emphasizes the importance of continuity of care and requires that the awarding commission consider organizations with a strong regional presence and those that prioritize local healthcare providers. The bill specifies that preference should be given to organizations that are locally managed and operational, particularly in the South Texas service region where access to care has been a significant concern.
Contention
There are notable points of contention surrounding the bill, particularly regarding the extent to which local organizations can compete against larger, national providers. Supporters argue that prioritizing local organizations will lead to better care tailored to community needs, while opponents express concerns that such preferences might limit competition and the potential cost-effectiveness of services. Additionally, the provision for re-evaluation of bids may lead to legal complications, as organizations currently in the bidding process may challenge the changes mid-evaluation.
Texas Constitutional Statutes Affected
Government Code
Chapter 540. Medicaid Managed Care Program
Section: 0204
Chapter 543. Clinical Initiatives To Improve Medicaid Quality Of Care And Cost-effectiveness
Section: New Section
Chapter 2155. Purchasing: General Rules And Procedures