Texas House Bill HB2245

Texas 2011 - 82nd Regular

• Introduced: 3/4/11
• Out of House Committee: 4/18/11
• Voted on by House: 4/27/11
• Refer: 3/10/11
• Out of Senate Committee: 5/11/11
• Report Pass: 4/13/11
• Voted on by Senate: 5/19/11
• Engrossed: 4/27/11
• Governor Action: 6/17/11
• Refer: 5/3/11
• Report Pass: 5/11/11
• Enrolled: 5/21/11
• Passed: 6/17/11

Caption

Relating to physician incentive programs to reduce hospital emergency room use for non-emergent conditions by Medicaid recipients.

Impact

The potential implications of HB2245 on state laws center on the modification of existing statutes to accommodate the evaluation and establishment of physician incentive programs. If successful, these programs could reshape how Medicaid recipients access healthcare, reinforcing the preference for primary care services over emergency visits for non-urgent issues. Such a shift could lead to legislative changes promoting preventative measures and better management of care to reduce unnecessary strain on emergency healthcare services, ultimately fostering a more efficient healthcare framework in Texas.

Summary

House Bill 2245 focuses on establishing physician incentive programs aimed at reducing non-emergent use of hospital emergency rooms by Medicaid recipients. The bill mandates the Texas Health and Human Services Commission to evaluate existing incentive programs, specifically those offered by health maintenance organizations participating in Medicaid's managed care programs. A key goal is to identify cost-effective strategies that encourage primary care providers to steer patients towards appropriate healthcare avenues instead of emergency services when not medically necessary. The importance of this legislation lies in addressing the overutilization of emergency services for non-urgent health issues, which places a significant burden on emergency departments and the broader healthcare system. The proposed study by the commission is set to analyze both the financial implications and potential changes in statute required to implement successful components of these incentive programs. Another notable point in HB2245 is the timeline for reporting findings, with a submission deadline to the governor and Legislative Budget Board by August 31, 2012. This provision ensures that the legislative body and executive oversight can make informed decisions moving forward, setting a foundation for program implementation that is both timely and data-driven. Furthermore, if the incentive program proposes enhanced reimbursement rates for after-hours appointments, the bill emphasizes the necessity to implement controls to certify that these services are genuinely being provided outside of regular business hours. This highlights a critical aspect of the bill, aiming to ensure accountability and integrity in the delivery of healthcare services in line with the proposed incentives.