Texas House Bill HB2222

Texas 2019 - 86th Regular

Caption

Relating to the administration and oversight of the Medicaid and child health plan programs.

Impact

The introduction of HB 2222 is expected to enhance the consistency and quality of healthcare services offered under the Medicaid program. By mandating accreditation for managed care organizations, the bill aims to ensure that only those organizations that meet established standards can provide services. Furthermore, the bill seeks to provide equitable access to healthcare services, helping to ensure that all recipients of Medicaid have a clearer understanding of their rights and the processes for enforcement. Additionally, through regular utilization reviews and financial audits, the bill emphasizes the importance of compliance and quality control in managing Medicaid services.

Summary

House Bill 2222 addresses the administration and oversight of the Medicaid and child health plan programs in Texas. Key provisions of the bill include the establishment of requirements for managed care organizations that provide healthcare services under these programs. This includes mandatory accreditation by a nationally recognized accrediting entity for managed care plans and implementing processes that govern the determination of medical necessity for services. The bill also introduces protections for providers, stating they shall not be liable for overpayments or debts determined by the commission if they have provided services in good faith under prior authorization.

Contention

One of the notable points of contention surrounding HB 2222 is the balance between regulation and the ability of providers to operate efficiently. While proponents argue that the bill's stringent requirements will lead to higher standards of care and accountability within managed care organizations, critics express concerns that increased regulation could create additional burdens for providers, potentially complicating the delivery of necessary services to vulnerable populations. These tensions suggest an ongoing debate about the optimal framework for managed care that adequately protects both recipients and providers in Texas.