Relating to the provision of Medicaid benefits under a fee-for-service delivery model.
If enacted, HB3700 would repeal Chapters 533 and 534 of the Government Code, which govern the managed care framework for Medicaid in Texas. This repeal would eliminate the current capitation-based payment system, suggesting a return to direct billing for services provided. The transition plan must be submitted by the commission to the governor, lieutenant governor, and legislature by November 2020, demonstrating the bill's emphasis on not just implementation but oversight of the shift back to fee-for-service.
House Bill 3700 proposes a significant shift in the way Medicaid benefits are delivered in Texas, transitioning from a managed care model back to a fee-for-service model. This bill amends Section 32.0212 of the Human Resources Code to mandate that medical assistance is provided solely through the fee-for-service delivery model. The intent behind this legislation is to restore what proponents believe to be a more effective way of delivering healthcare to recipients that allows greater flexibility in service provision.
The introduction of this bill may lead to significant debate amongst stakeholders in the healthcare community. Advocates of the fee-for-service model argue that it promotes better patient care by allowing healthcare providers to deliver services as needed without the constraints imposed by managed care, which can prioritize cost savings over patient welfare. On the other hand, opponents of the bill may raise concerns regarding the potential for increased costs to the state and the complications involved in dismantling existing managed care contracts, as well as the possibility of reduced access to care for certain populations.
The bill's passage could hinge on the outcomes of discussions regarding the fiscal implications for the state, the quality of care that patients receive under a fee-for-service model, and the ability to effectively transition from managed care. Moreover, the requirement for state agencies to seek federal waivers if necessary for implementation further complicates the timeline and feasibility of restoring a fee-for-service system.