Texas 2011 - 82nd Regular

Texas House Bill HB13 Compare Versions

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1	1	By: Kolkhorst, et al. (Senate Sponsor - Nelson) H.B. No. 13
2	2	(In the Senate - Received from the House May 12, 2011;
3	3	May 13, 2011, read first time and referred to Committee on Health
4	4	and Human Services; May 20, 2011, reported adversely, with
5	5	favorable Committee Substitute by the following vote: Yeas 5,
6	6	Nays 4; May 20, 2011, sent to printer.)
7	7	COMMITTEE SUBSTITUTE FOR H.B. No. 13 By: Nelson
8	8
9	9
10	10	A BILL TO BE ENTITLED
11	11	AN ACT
12	12	relating to the Medicaid program and alternate methods of providing
13	13	health services to low-income persons in this state.
14	14	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
15	15	SECTION 1. Subtitle I, Title 4, Government Code, is amended
16	16	by adding Chapter 536 to read as follows:
17	17	CHAPTER 536. MEDICAID REFORM WAIVER
18	18	Sec. 536.001. DEFINITIONS. In this chapter:
19	19	(1) "Commission" means the Health and Human Services
20	20	Commission.
21	21	(2) "Executive commissioner" means the executive
22	22	commissioner of the Health and Human Services Commission.
23	23	Sec. 536.002. FEDERAL AUTHORIZATION FOR MEDICAID REFORM.
24	24	(a) The executive commissioner shall seek a waiver under Section
25	25	1115 of the federal Social Security Act (42 U.S.C. Section 1315) to
26	26	the state Medicaid plan.
27	27	(b) The waiver under this section must be designed to
28	28	achieve the following objectives regarding the Medicaid program and
29	29	alternatives to the program:
30	30	(1) provide flexibility to determine Medicaid
31	31	eligibility categories and income levels;
32	32	(2) provide flexibility to design Medicaid benefits
33	33	that meet the demographic, public health, clinical, and cultural
34	34	needs of this state or regions within this state;
35	35	(3) encourage use of the private health benefits
36	36	coverage market rather than public benefits systems;
37	37	(4) encourage people who have access to private
38	38	employer-based health benefits to obtain or maintain those
39	39	benefits;
40	40	(5) create a culture of shared financial
41	41	responsibility, accountability, and participation in the Medicaid
42	42	program by:
43	43	(A) establishing and enforcing copayment
44	44	requirements similar to private sector principles for all
45	45	eligibility groups;
46	46	(B) promoting the use of health savings accounts
47	47	to influence a culture of individual responsibility; and
48	48	(C) promoting the use of vouchers for
49	49	consumer-directed services in which consumers manage and pay for
50	50	health-related services provided to them using program vouchers;
51	51	(6) consolidate federal funding streams, including
52	52	funds from the disproportionate share hospitals and upper payment
53	53	limit supplemental payment programs and other federal Medicaid
54	54	funds, to ensure the most effective and efficient use of those
55	55	funding streams;
56	56	(7) allow flexibility in the use of state funds used to
57	57	obtain federal matching funds, including allowing the use of
58	58	intergovernmental transfers, certified public expenditures, costs
59	59	not otherwise matchable, or other funds and funding mechanisms to
60	60	obtain federal matching funds;
61	61	(8) empower individuals who are uninsured to acquire
62	62	health benefits coverage through the promotion of cost-effective
63	63	coverage models that provide access to affordable primary,
64	64	preventive, and other health care on a sliding scale, with fees paid
65	65	at the point of service; and
66	66	(9) allow for the redesign of long-term care services
67	67	and supports to increase access to person-centered care in the most
68	68	cost-effective manner.
69	69	SECTION 2. (a) In this section:
70	70	(1) "Commission" means the Health and Human Services
71	71	Commission.
72	72	(2) "FMAP" means the federal medical assistance
73	73	percentage by which state expenditures under the Medicaid program
74	74	are matched with federal funds.
75	75	(3) "Illegal immigrant" means an individual who is not
76	76	a citizen or national of the United States and who is unlawfully
77	77	present in the United States.
78	78	(4) "Medicaid program" means the medical assistance
79	79	program under Chapter 32, Human Resources Code.
80	80	(b) The commission shall actively pursue a modification to
81	81	the formula prescribed by federal law for determining this state's
82	82	FMAP to achieve a formula that would produce an FMAP that accounts
83	83	for and is periodically adjusted to reflect changes in the
84	84	following factors in this state:
85	85	(1) the total population;
86	86	(2) the population growth rate; and
87	87	(3) the percentage of the population with household
88	88	incomes below the federal poverty level.
89	89	(c) The commission shall pursue the modification as
90	90	required by Subsection (b) of this section by providing to the Texas
91	91	delegation to the United States Congress and the federal Centers
92	92	for Medicare and Medicaid Services and other appropriate federal
93	93	agencies data regarding the factors listed in that subsection and
94	94	information indicating the effects of those factors on the Medicaid
95	95	program that are unique to this state.
96	96	(d) In addition to the modification to the FMAP described by
97	97	Subsection (b) of this section, the commission shall make efforts
98	98	to obtain additional federal Medicaid funding for Medicaid services
99	99	required to be provided to illegal immigrants in this state. As
100	100	part of that effort, the commission shall provide to the Texas
101	101	delegation to the United States Congress and the federal Centers
102	102	for Medicare and Medicaid Services and other appropriate federal
103	103	agencies data regarding the costs to this state of providing those
104	104	services.
105	105	(e) This section expires September 1, 2013.
106	106	SECTION 3. (a) The Medicaid Reform Waiver Legislative
107	107	Oversight Committee is created to facilitate the reform waiver
108	108	efforts with respect to Medicaid.
109	109	(b) The committee is composed of eight members, as follows:
110	110	(1) four members of the senate, appointed by the
111	111	lieutenant governor not later than October 1, 2011; and
112	112	(2) four members of the house of representatives,
113	113	appointed by the speaker of the house of representatives not later
114	114	than October 1, 2011.
115	115	(c) A member of the committee serves at the pleasure of the
116	116	appointing official.
117	117	(d) The lieutenant governor shall designate a member of the
118	118	committee as the presiding officer.
119	119	(e) A member of the committee may not receive compensation
120	120	for serving on the committee but is entitled to reimbursement for
121	121	travel expenses incurred by the member while conducting the
122	122	business of the committee as provided by the General Appropriations
123	123	Act.
124	124	(f) The committee shall:
125	125	(1) facilitate the design and development of the
126	126	Medicaid reform waiver required by Chapter 536, Government Code, as
127	127	added by this Act;
128	128	(2) facilitate a smooth transition from existing
129	129	Medicaid payment systems and benefit designs to a new model of
130	130	Medicaid enabled by the waiver described by Subdivision (1) of this
131	131	subsection;
132	132	(3) meet at the call of the presiding officer; and
133	133	(4) research, take public testimony, and issue reports
134	134	requested by the lieutenant governor or speaker of the house of
135	135	representatives.
136	136	(g) The committee may request reports and other information
137	137	from the Health and Human Services Commission.
138	138	(h) The committee shall use existing staff of the senate,
139	139	the house of representatives, and the Texas Legislative Council to
140	140	assist the committee in performing its duties under this section.
141	141	(i) Chapter 551, Government Code, applies to the committee.
142	142	(j) The committee shall report to the lieutenant governor
143	143	and speaker of the house of representatives not later than November
144	144	15, 2012. The report must include:
145	145	(1) identification of significant issues that impede
146	146	the transition to a more effective Medicaid program;
147	147	(2) the measures of effectiveness associated with
148	148	changes to the Medicaid program;
149	149	(3) the impact of Medicaid changes on safety net
150	150	hospitals and other significant traditional providers; and
151	151	(4) the impact on the uninsured in Texas.
152	152	(k) This section expires September 1, 2013, and the
153	153	committee is abolished on that date.
154	154	SECTION 4. This Act takes effect immediately if it receives
155	155	a vote of two-thirds of all the members elected to each house, as
156	156	provided by Section 39, Article III, Texas Constitution. If this
157	157	Act does not receive the vote necessary for immediate effect, this
158	158	Act takes effect September 1, 2011.
159	159	* * * * *