| 1 | 1 | | By: Nelson S.B. No. 2128 |
|---|
| 2 | 2 | | |
|---|
| 3 | 3 | | |
|---|
| 4 | 4 | | A BILL TO BE ENTITLED |
|---|
| 5 | 5 | | AN ACT |
|---|
| 6 | 6 | | relating to the Health and Human Services Commission's procurement |
|---|
| 7 | 7 | | and oversight of managed care organization contracts serving |
|---|
| 8 | 8 | | individuals in Texas Medicaid with serious mental illness. |
|---|
| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|---|
| 10 | 10 | | SECTION 1. Section 533.0071, Texas Government Code, is |
|---|
| 11 | 11 | | amended by adding new subsection "(6)" to read as follows: |
|---|
| 12 | 12 | | " (6) To achieve greater administrative efficiency and the |
|---|
| 13 | 13 | | greatest value for the state, the Health and Human Services |
|---|
| 14 | 14 | | Commission shall evaluate and strengthen its current procurement |
|---|
| 15 | 15 | | process for managed care. This may include simultaneously procuring |
|---|
| 16 | 16 | | multiple managed care products. |
|---|
| 17 | 17 | | The agency shall develop metrics to better hold managed care |
|---|
| 18 | 18 | | companies accountable for care of enrollees with serious mental |
|---|
| 19 | 19 | | illness, which may include development and procurement of a |
|---|
| 20 | 20 | | separate managed care program in at least one service area of the |
|---|
| 21 | 21 | | state aimed at serving individuals with serious mental illness, as |
|---|
| 22 | 22 | | defined by Section 1355.001, Texas Insurance Code. |
|---|
| 23 | 23 | | The Health and Human Services Commission shall measure |
|---|
| 24 | 24 | | performance of all managed care programs per Government Code, |
|---|
| 25 | 25 | | 536.003 and by using other measures that support a continuous |
|---|
| 26 | 26 | | quality improvement process and establish accountability at the |
|---|
| 27 | 27 | | managed care organization and provider level for performance |
|---|
| 28 | 28 | | improvement and cost control. Measures should include national |
|---|
| 29 | 29 | | industry standard performance measures for integrated care, jail |
|---|
| 30 | 30 | | and emergency department diversion, post-release linkage to care, |
|---|
| 31 | 31 | | homelessness reduction, supportive housing, and medication |
|---|
| 32 | 32 | | adherence. Metrics also must demonstrate improved outcomes and |
|---|
| 33 | 33 | | integration of care and enhanced cost control against an |
|---|
| 34 | 34 | | established baseline measurement for the target population of |
|---|
| 35 | 35 | | individuals with serious mental illness. |
|---|
| 36 | 36 | | If necessary, the Health and Human Services Commission may |
|---|
| 37 | 37 | | extend existing managed care contracts to establish a uniform |
|---|
| 38 | 38 | | expiration date, provided it does so in a manner consistent with |
|---|
| 39 | 39 | | Texas Government Code section 2155.144(c)." |
|---|
| 40 | 40 | | SECTION 2. This Act takes effect immediately if it receives |
|---|
| 41 | 41 | | a vote of two-thirds of all the members elected to each house, as |
|---|
| 42 | 42 | | provided by Section 39, Article III, Texas Constitution. If this |
|---|
| 43 | 43 | | Act does not receive the vote necessary for immediate effect, this |
|---|
| 44 | 44 | | Act takes effect September 1, 2017. |
|---|