Texas 2011 - 82nd 1st C.S.

Texas House Bill HB13 Compare Versions

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1	1	82S10017 ALB-D
2	2	By: Kolkhorst H.B. No. 13
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the Medicaid program and alternate methods of providing
8	8	health services to low-income persons in this state.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle I, Title 4, Government Code, is amended
11	11	by adding Chapter 537 to read as follows:
12	12	CHAPTER 537. MEDICAID REFORM WAIVER
13	13	Sec. 537.001. DEFINITIONS. In this chapter:
14	14	(1) "Commission" means the Health and Human Services
15	15	Commission.
16	16	(2) "Executive commissioner" means the executive
17	17	commissioner of the Health and Human Services Commission.
18	18	Sec. 537.002. FEDERAL AUTHORIZATION FOR MEDICAID REFORM.
19	19	(a) The executive commissioner shall seek a waiver under Section
20	20	1115 of the federal Social Security Act (42 U.S.C. Section 1315) to
21	21	the state Medicaid plan.
22	22	(b) The waiver under this section must be designed to
23	23	achieve the following objectives regarding the Medicaid program and
24	24	alternatives to the program:
25	25	(1) provide flexibility to determine Medicaid
26	26	eligibility categories and income levels;
27	27	(2) provide flexibility to design Medicaid benefits
28	28	that meet the demographic, public health, clinical, and cultural
29	29	needs of this state or regions within this state;
30	30	(3) encourage use of the private health benefits
31	31	coverage market rather than public benefits systems;
32	32	(4) encourage people who have access to private
33	33	employer-based health benefits to obtain or maintain those
34	34	benefits;
35	35	(5) create a culture of shared financial
36	36	responsibility, accountability, and participation in the Medicaid
37	37	program by:
38	38	(A) establishing and enforcing copayment
39	39	requirements similar to private sector principles for all
40	40	eligibility groups;
41	41	(B) promoting the use of health savings accounts
42	42	to influence a culture of individual responsibility; and
43	43	(C) promoting the use of vouchers for
44	44	consumer-directed services in which consumers manage and pay for
45	45	health-related services provided to them using program vouchers;
46	46	(6) consolidate federal funding streams, including
47	47	funds from the disproportionate share hospitals and upper payment
48	48	limit supplemental payment programs and other federal Medicaid
49	49	funds, to ensure the most effective and efficient use of those
50	50	funding streams;
51	51	(7) allow flexibility in the use of state funds used to
52	52	obtain federal matching funds, including allowing the use of
53	53	intergovernmental transfers, certified public expenditures, costs
54	54	not otherwise matchable, or other funds and funding mechanisms to
55	55	obtain federal matching funds;
56	56	(8) empower individuals who are uninsured to acquire
57	57	health benefits coverage through the promotion of cost-effective
58	58	coverage models that provide access to affordable primary,
59	59	preventive, and other health care on a sliding scale, with fees paid
60	60	at the point of service; and
61	61	(9) allow for the redesign of long-term care services
62	62	and supports to increase access to patient-centered care in the
63	63	most cost-effective manner.
64	64	SECTION 2. (a) In this section:
65	65	(1) "Commission" means the Health and Human Services
66	66	Commission.
67	67	(2) "FMAP" means the federal medical assistance
68	68	percentage by which state expenditures under the Medicaid program
69	69	are matched with federal funds.
70	70	(3) "Illegal immigrant" means an individual who is not
71	71	a citizen or national of the United States and who is unlawfully
72	72	present in the United States.
73	73	(4) "Medicaid program" means the medical assistance
74	74	program under Chapter 32, Human Resources Code.
75	75	(b) The commission shall actively pursue a modification to
76	76	the formula prescribed by federal law for determining this state's
77	77	FMAP to achieve a formula that would produce an FMAP that accounts
78	78	for and is periodically adjusted to reflect changes in the
79	79	following factors in this state:
80	80	(1) the total population;
81	81	(2) the population growth rate; and
82	82	(3) the percentage of the population with household
83	83	incomes below the federal poverty level.
84	84	(c) The commission shall pursue the modification as
85	85	required by Subsection (b) of this section by providing to the Texas
86	86	delegation to the United States Congress and the federal Centers
87	87	for Medicare and Medicaid Services and other appropriate federal
88	88	agencies data regarding the factors listed in that subsection and
89	89	information indicating the effects of those factors on the Medicaid
90	90	program that are unique to this state.
91	91	(d) In addition to the modification to the FMAP described by
92	92	Subsection (b) of this section, the commission shall make efforts
93	93	to obtain additional federal Medicaid funding for Medicaid services
94	94	required to be provided to illegal immigrants in this state. As
95	95	part of that effort, the commission shall provide to the Texas
96	96	delegation to the United States Congress and the federal Centers
97	97	for Medicare and Medicaid Services and other appropriate federal
98	98	agencies data regarding the costs to this state of providing those
99	99	services.
100	100	(e) This section expires September 1, 2013.
101	101	SECTION 3. (a) The Medicaid Reform Waiver Legislative
102	102	Oversight Committee is created to facilitate the reform waiver
103	103	efforts with respect to Medicaid.
104	104	(b) The committee is composed of eight members, as follows:
105	105	(1) four members of the senate, appointed by the
106	106	lieutenant governor not later than October 1, 2011; and
107	107	(2) four members of the house of representatives,
108	108	appointed by the speaker of the house of representatives not later
109	109	than October 1, 2011.
110	110	(c) A member of the committee serves at the pleasure of the
111	111	appointing official.
112	112	(d) The speaker of the house of representatives shall
113	113	designate a member of the committee as the presiding officer.
114	114	(e) A member of the committee may not receive compensation
115	115	for serving on the committee but is entitled to reimbursement for
116	116	travel expenses incurred by the member while conducting the
117	117	business of the committee as provided by the General Appropriations
118	118	Act.
119	119	(f) The committee shall:
120	120	(1) facilitate the design and development of the
121	121	Medicaid reform waiver required by Chapter 537, Government Code, as
122	122	added by this Act;
123	123	(2) facilitate a smooth transition from existing
124	124	Medicaid payment systems and benefit designs to a new model of
125	125	Medicaid enabled by the waiver described by Subdivision (1) of this
126	126	subsection;
127	127	(3) meet at the call of the presiding officer; and
128	128	(4) research, take public testimony, and issue reports
129	129	requested by the lieutenant governor or speaker of the house of
130	130	representatives.
131	131	(g) The committee may request reports and other information
132	132	from the Health and Human Services Commission.
133	133	(h) The committee shall use existing staff of the senate,
134	134	the house of representatives, and the Texas Legislative Council to
135	135	assist the committee in performing its duties under this section.
136	136	(i) Chapter 551, Government Code, applies to the committee.
137	137	(j) The committee shall report to the lieutenant governor
138	138	and speaker of the house of representatives not later than November
139	139	15, 2012. The report must include:
140	140	(1) identification of significant issues that impede
141	141	the transition to a more effective Medicaid program;
142	142	(2) the measures of effectiveness associated with
143	143	changes to the Medicaid program;
144	144	(3) the impact of Medicaid changes on safety net
145	145	hospitals and other significant traditional providers; and
146	146	(4) the impact on the uninsured in Texas.
147	147	(k) This section expires September 1, 2013, and the
148	148	committee is abolished on that date.
149	149	SECTION 4. This Act takes effect immediately if it receives
150	150	a vote of two-thirds of all the members elected to each house, as
151	151	provided by Section 39, Article III, Texas Constitution. If this
152	152	Act does not receive the vote necessary for immediate effect, this
153	153	Act takes effect on the 91st day after the last day of the
154	154	legislative session.