| 1 | 1 | | 84R4848 LED-D |
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| 2 | 2 | | By: Guillen H.B. No. 1093 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to transparency in the STAR Medicaid managed care |
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| 8 | 8 | | rate-setting process. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subchapter A, Chapter 533, Government Code, is |
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| 11 | 11 | | amended by adding Section 533.01314 to read as follows: |
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| 12 | 12 | | Sec. 533.01314. TRANSPARENCY OF PREMIUM PAYMENT |
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| 13 | 13 | | RATE-SETTING PROCESS FOR STAR MEDICAID MANAGED CARE PROGRAM. The |
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| 14 | 14 | | commission shall ensure the transparency of the premium payment |
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| 15 | 15 | | rate-setting process for the STAR Medicaid managed care program by |
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| 16 | 16 | | publishing actuarial reports: |
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| 17 | 17 | | (1) in a format that allows for tracing data and |
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| 18 | 18 | | formulas across attachments, exhibits, and examples; and |
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| 19 | 19 | | (2) that clearly identify and describe: |
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| 20 | 20 | | (A) the methodology by which the executive |
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| 21 | 21 | | commissioner set the payment rates; |
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| 22 | 22 | | (B) the data sources used; |
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| 23 | 23 | | (C) the components of the process that are |
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| 24 | 24 | | assumptions and how the assumptions are developed; and |
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| 25 | 25 | | (D) multipliers and factors used throughout the |
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| 26 | 26 | | reports, including the source and purpose of the multipliers and |
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| 27 | 27 | | factors. |
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| 28 | 28 | | SECTION 2. If before implementing any provision of this Act |
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| 29 | 29 | | a state agency determines that authorization from a federal agency |
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| 30 | 30 | | is necessary for implementation of that provision, the agency |
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| 31 | 31 | | affected by the provision shall request the authorization and may |
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| 32 | 32 | | delay implementing that provision until the authorization is |
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| 33 | 33 | | granted. |
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| 34 | 34 | | SECTION 3. This Act takes effect September 1, 2015. |
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