Texas 2017 - 85th Regular

Texas Senate Bill SB2223 Compare Versions

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

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1	1	By: Rodríguez S.B. No. 2223
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to Medicaid funding in this state, including the federal
7	7	government's participation in that funding.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 531.02113, Government Code, is amended
10	10	to read as follows:
11	11	Sec. 531.02113. OPTIMIZATION OF MEDICAID FINANCING. The
12	12	commission shall ensure that the Medicaid finance system:
13	13	(1) is optimized to:
14	14	(A) [(1)] maximize the state's receipt of
15	15	federal funds;
16	16	(B) [(2)] create incentives for providers to use
17	17	preventive care;
18	18	(C) [(3)] increase and retain providers in the
19	19	system to maintain an adequate provider network;
20	20	(D) [(4)] more accurately reflect the costs
21	21	borne by providers; and
22	22	(E) [(5)] encourage the improvement of the
23	23	quality of care; and
24	24	(2) complies with the requirements of Chapter 540, if
25	25	applicable.
26	26	SECTION 2. Subtitle I, Title 4, Government Code, is amended
27	27	by adding Chapter 540 to read as follows:
28	28	CHAPTER 540. MEDICAID FUNDING MODIFICATION
29	29	Sec. 540.0001. APPLICABILITY. This chapter applies to a
30	30	waiver to the requirements of this state's Medicaid state plan or
31	31	other authorization under Medicaid:
32	32	(1) for which the commission seeks approval from the
33	33	federal government; and
34	34	(2) that, if approved, would change this state's
35	35	receipt of federal money for Medicaid from the funding system in
36	36	effect on January 1, 2017, to a block grant or other funding system.
37	37	Sec. 540.0002. PRIMARY GOAL OF MEDICAID FUNDING
38	38	MODIFICATION. (a) The primary goal of a Medicaid funding
39	39	modification the commission seeks through a waiver or other
40	40	authorization to which this chapter applies must be to preserve the
41	41	best interests of the residents of this state.
42	42	(b) The commission may not seek a waiver or other
43	43	authorization to which this chapter applies that is contrary to the
44	44	primary goal specified by Subsection (a) or that otherwise does not
45	45	meet the requirements of this chapter.
46	46	Sec. 540.0003. ADEQUACY OF MEDICAID PROGRAM FUNDING. A
47	47	Medicaid funding modification the commission seeks through a waiver
48	48	or other authorization to which this chapter applies:
49	49	(1) must account for and ensure adequate, continued
50	50	funding for:
51	51	(A) anticipated growth in the number of persons
52	52	in this state who will be eligible for and enroll in the Medicaid
53	53	program; and
54	54	(B) health care trends that may affect costs,
55	55	including:
56	56	(i) increases in utilization rates;
57	57	(ii) increases in the acuity of Medicaid
58	58	recipients;
59	59	(iii) advancements in medical technology;
60	60	and
61	61	(iv) advancements in specialized
62	62	prescription drugs; and
63	63	(2) may not be designed in a manner that allows for
64	64	reductions in federal financial participation based on this state's
65	65	effective management of Medicaid cost growth.
66	66	Sec. 540.0004. MAINTENANCE OF ELIGIBILITY REQUIREMENTS AND
67	67	COVERED SERVICES. A waiver or other authorization to which this
68	68	chapter applies must ensure that, at a minimum:
69	69	(1) the eligibility criteria for full Medicaid
70	70	benefits in effect on January 1, 2017, are not made more restrictive
71	71	under the waiver or authorization, including the eligibility
72	72	criteria for low-income families, pregnant women, children,
73	73	persons who are 65 years of age or older, and persons with
74	74	disabilities;
75	75	(2) the eligibility criteria for limited Medicaid
76	76	benefits in effect on January 1, 2017, are not made more restrictive
77	77	under the waiver or authorization; and
78	78	(3) all acute care services and long-term services and
79	79	supports covered by Medicaid on January 1, 2017, continue to be
80	80	covered, regardless of whether those services are mandatory or
81	81	optional services under federal law.
82	82	Sec. 540.0005. PROVIDER REIMBURSEMENTS AND OTHER PAYMENTS.
83	83	(a) A waiver or other authorization to which this chapter applies
84	84	must ensure that the Medicaid funding modification the commission
85	85	seeks through the waiver or authorization will:
86	86	(1) support the provision of adequate reimbursements
87	87	to Medicaid providers, require reimbursement rates for those
88	88	providers for the provision of Medicaid services to be at least
89	89	equal to the rates in effect on January 1, 2017, and support
90	90	periodic reimbursement rate increases based on health care trends;
91	91	(2) ensure continued provision of payments to
92	92	hospitals equal to supplemental payments by this state to hospitals
93	93	under supplemental payment programs in effect on January 1, 2017,
94	94	which may include continued provision through increases in rates
95	95	paid for direct hospital services to Medicaid enrollees; and
96	96	(3) prioritize use of supplemental payments to
97	97	encourage continued development of comprehensive local and
98	98	regional health care systems that include preventive, primary,
99	99	specialty, outpatient, inpatient, mental health, and substance
100	100	abuse services for individuals without health insurance.
101	101	(b) Reimbursement systems under a waiver or other
102	102	authorization to which this chapter applies must encourage
103	103	value-based payment arrangements for Medicaid providers and
104	104	support efforts to promote quality of care.
105	105	SECTION 3. This Act takes effect immediately if it receives
106	106	a vote of two-thirds of all the members elected to each house, as
107	107	provided by Section 39, Article III, Texas Constitution. If this
108	108	Act does not receive the vote necessary for immediate effect, this
109	109	Act takes effect September 1, 2017.