Texas 2017 - 85th Regular

Texas House Bill HB1524 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	85R8360 LED-D
2	2	By: Muñoz, Jr. H.B. No. 1524
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to transparency in the rate-setting processes for the
8	8	Medicaid managed care and child health plan programs.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter A, Chapter 533, Government Code, is
11	11	amended by adding Section 533.01314 to read as follows:
12	12	Sec. 533.01314. TRANSPARENCY OF PREMIUM PAYMENT
13	13	RATE-SETTING PROCESS FOR MEDICAID MANAGED CARE PROGRAM. (a) The
14	14	commission shall ensure the transparency of the premium payment
15	15	rate-setting process for the Medicaid managed care program by
16	16	publishing actuarial reports:
17	17	(1) in a format that allows for tracing data and
18	18	formulas across attachments, exhibits, and examples; and
19	19	(2) that clearly identify and describe:
20	20	(A) the methodology by which the executive
21	21	commissioner set the payment rates;
22	22	(B) the data sources used;
23	23	(C) the components of the process that are
24	24	assumptions and how the assumptions are developed;
25	25	(D) multipliers and factors used throughout the
26	26	reports, including the source and purpose of the multipliers and
27	27	factors; and
28	28	(E) the methodology by which the executive
29	29	commissioner determined that the rates are actuarially sound for
30	30	the populations covered and the services provided.
31	31	(b) Notwithstanding Subsection (a), the commission is not
32	32	required to publish particular information in an actuarial report
33	33	if the commission determines the information is proprietary.
34	34	SECTION 2. Subchapter B, Chapter 62, Health and Safety
35	35	Code, is amended by adding Section 62.061 to read as follows:
36	36	Sec. 62.061. TRANSPARENCY OF PREMIUM PAYMENT RATE-SETTING
37	37	PROCESS. (a) The commission shall ensure the transparency of the
38	38	premium payment rate-setting process for the child health plan
39	39	program by publishing actuarial reports:
40	40	(1) in a format that allows for tracing data and
41	41	formulas across attachments, exhibits, and examples; and
42	42	(2) that clearly identify and describe:
43	43	(A) the methodology by which the executive
44	44	commissioner set the payment rates;
45	45	(B) the data sources used;
46	46	(C) the components of the process that are
47	47	assumptions and how the assumptions are developed;
48	48	(D) multipliers and factors used throughout the
49	49	reports, including the source and purpose of the multipliers and
50	50	factors; and
51	51	(E) the methodology by which the executive
52	52	commissioner determined that the rates are actuarially sound for
53	53	the populations covered and the services provided.
54	54	(b) Notwithstanding Subsection (a), the commission is not
55	55	required to publish particular information in an actuarial report
56	56	if the commission determines the information is proprietary.
57	57	SECTION 3. If before implementing any provision of this Act
58	58	a state agency determines that a waiver or authorization from a
59	59	federal agency is necessary for implementation of that provision,
60	60	the agency affected by the provision shall request the waiver or
61	61	authorization and may delay implementing that provision until the
62	62	waiver or authorization is granted.
63	63	SECTION 4. This Act takes effect September 1, 2017.