Texas House Bill HB3670

Texas 2019 - 86th Regular

Caption

Relating to the administration and operation of the Medicaid program.

Impact

The enactment of HB 3670 is expected to have a considerable impact on both the delivery and funding of healthcare services under the Medicaid program. By allowing the Health and Human Services Commission to eliminate prior authorization for generic drugs, the bill aims to enhance access to necessary medications for low-income individuals. Additionally, the changes to contract requirements for managed care organizations would hold them accountable for the timely processing of claims, potentially improving the overall efficiency of the Medicaid system in Texas.

Summary

House Bill 3670 proposes significant changes to the management and operation of Texas's Medicaid program. The bill amends several sections of the Government Code related to the Medicaid vendor drug program and the authority of managed care organizations. One of the key elements includes a requirement for prior authorization for drugs that are not included in the preferred drug list, but it specifically exempts generic prescription drugs from prior authorization requirements. This change is aimed at streamlining access to medications for Medicaid recipients while potentially reducing administrative burdens on healthcare providers.

Contention

Notably, the bill has faced contention regarding its implications for healthcare provider operations, especially how changes in reimbursement rates and practices might affect their financial viability. While proponents argue that reducing bureaucratic hurdles will aid patients in obtaining medications quickly, critics express concern about the adequacy of healthcare services delivered by managed care organizations and whether such changes could lead to cost-cutting measures that might compromise provider reimbursement and potentially affect the quality of care delivered to Medicaid recipients.