Texas House Bill HB220

Texas 2019 - 86th Regular

Caption

Relating to reimbursement of health care providers under Medicaid.

Impact

The implications of HB220 are notable for both healthcare providers and Medicaid recipients. By allowing negotiations that align reimbursement with market rates, the bill may help improve the financial viability of providers who serve Medicaid recipients, particularly in underserved areas. Moreover, it is expected to expedite the payment process, as the bill mandates that claims be paid within 45 days of receipt or as per mutual agreements between providers and payers, thereby improving cash flow for healthcare providers.

Summary

House Bill 220 aims to enhance the reimbursement process for healthcare providers under the Medicaid program in Texas. The bill introduces a provision allowing healthcare providers to negotiate their reimbursement rates with managed care organizations, ensuring these rates are comparable to prevailing market rates. This is a significant shift in the way payments are structured, as it provides providers with more leverage in negotiations, potentially leading to better compensation for their services.

Contention

While there seems to be general support for the bill from healthcare providers advocating for fair pay, it may introduce complexities regarding the negotiation process and the operational responsibilities of managed care organizations. There are concerns that such negotiations could lead to discrepancies in reimbursement rates amongst providers, depending on their bargaining power. Additionally, there are fears that while some providers might benefit from better rates, others may see declines in their operational funding if negotiations do not lead to favorable outcomes.