TX
Texas Senate Bill SB1776

Texas 2017 - 85th Regular

Texas Senate Bill SB1776

Caption

Relating to the administration and operation of the Medicaid program in a managed care model.

Impact

The bill introduces significant changes to how MCOs operate, specifically by holding them accountable for prompt reimbursement to healthcare providers and ensuring that claims related to services rendered are processed within specified timelines. Moreover, it aims to standardize protocols around medical necessity determinations and care coordination services, potentially improving health outcomes for Medicaid recipients throughout Texas.

Summary

Senate Bill 1776 focuses on enhancing the administration and operation of Texas's Medicaid program under a managed care model. It emphasizes accountability, timely claims payment, and improved service delivery within the state healthcare systems. Key provisions include requirements for managed care organizations (MCOs) to establish effective communication channels for both recipients and providers, ensuring quick resolution of payment disputes and provision of healthcare services.

Contention

Despite its aims to enhance the efficiency of Medicaid services, SB1776 faces contention around the impact on existing provider networks and operational flexibility of MCOs. Critics express concerns that the rigid requirements could overwhelm smaller healthcare providers and stifle their ability to operate effectively within the Medicaid framework. Additionally, there is debate surrounding the balance between oversight by the state and the administrative burden this may place on managed care entities, which could influence the availability and quality of care for recipients.

Companion Bills

No companion bills found.

Previously Filed As

TX HB1283

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX SB1113

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX HB4111

Relating to access to and the provision of behavioral and mental health care services and trauma-informed care in the Medicaid managed care program.

TX HB1293

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB2401

Relating to certain contracting requirements under the Medicaid managed care delivery model.

TX HB4611

Relating to the nonsubstantive revision of the health and human services laws governing the Health and Human Services Commission, Medicaid, and other social services.

TX HB2778

Relating to the operation and administration of the State Office of Administrative Hearings.

TX SB1432

Relating to the operation and administration of the State Office of Administrative Hearings.

TX SB2402

Relating to the creation, management, and administration of the Texas Pharmaceutical Initiative.

TX HB4835

Relating to the creation and operations of certain health care provider participation programs.

Similar Bills

TX HB3982

Relating to the Medicaid program, including the administration and operation of the Medicaid managed care program.

TX HB3388

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX SB1567

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB3288

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB1133

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB3366

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX SB1612

Relating to the reimbursement of prescription drugs under the Medicaid managed care and child health plan programs.

TX SB1922

Relating to contract requirements for prescription drug benefits provided by Medicaid managed care organizations and a study regarding Medicaid prior authorization requirements for certain prescription drugs.