Texas Senate Bill SB2228

Texas 2017 - 85th Regular

Caption

Relating to the provision of eye health care by certain professionals and institutions as providers in the Medicaid managed care program.

Impact

By facilitating direct access to qualified eye health care professionals, SB2228 promises to enhance the quality and timeliness of eye care for Medicaid recipients. It will likely increase enrollment of optometrists and ophthalmologists into the Medicaid program, thereby introducing a wider pool of providers. Additionally, institutions of higher education that offer training for these fields are also included, which could foster a greater emphasis on eye health care education and accessibility in the state.

Summary

SB2228 focuses on expanding access to eye health care services under Texas's Medicaid managed care program. The bill amends existing provisions in the Human Resources Code, allowing recipients of medical assistance the right to choose their eye care providers, namely ophthalmologists and therapeutic optometrists, without needing referrals or prior authorizations for nonsurgical services. This provision aims to streamline the process for patients seeking eye care, ensuring they receive necessary services more efficiently.

Contention

Despite these positive outcomes, some concerns have been raised regarding potential overreach by the Health and Human Services Commission in the context of Medicaid managed care contracts. Critics argue that the requirement to include all licensed optometrists and ophthalmologists in provider networks may create challenges in network management and may dilute quality control. Moreover, there are varying opinions on how this bill balances the need for accessibility against ensuring that providers meet the necessary standards of care.