Texas House Bill HB3937

Texas 2019 - 86th Regular

Caption

Relating to a report regarding Medicaid reimbursement rates and access to care.

Impact

The findings of the commission, to be reported by December 1, 2020, are set to inform legislative discussions and potential revisions to Medicaid policies and funding. The report is expected to highlight regional disparities in access to Medicaid-funded care, thereby providing law-makers with data necessary for making informed decisions on legislative adjustments that could better align reimbursement rates with provider capabilities and patient needs. This could potentially open pathways for increasing provider participation, thereby improving access to care for Medicaid recipients across Texas.

Summary

House Bill 3937 aims to enhance transparency and evaluation of the Medicaid reimbursement rates and the access to care within the Medicaid program in Texas. The bill mandates the Health and Human Services Commission to compile a comprehensive report that investigates various elements influencing the reimbursement methodologies utilized by Medicaid managed care organizations. It requires an analysis of the current reimbursement framework, the implications of previously established rates, and uncontested care costs, along with comparing provider involvement across different regions and specialties.

Contention

Debate surrounding HB3937 may arise from differing opinions on the methods of determining fair provider compensation and the evaluation of access to care standards. Some stakeholders may argue that the proposed changes might not adequately address the core issues leading to reduced provider participation, particularly in counties experiencing shortages. Critics may also be concerned about the feasibility and cost of implementing a minimum fee schedule, especially in regions with lower Medicaid populations, further instigating discussions on general Medicaid reform and provider incentives.