Texas 2019 - 86th Regular

Texas House Bill HB3937 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	86R14212 LED-D
2	2	By: González of El Paso H.B. No. 3937
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a report regarding Medicaid reimbursement rates and
8	8	access to care.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. (a) In this section, "commission" means the
11	11	Health and Human Services Commission.
12	12	(b) The commission shall prepare a written report regarding
13	13	provider reimbursement rates and access to care in the Medicaid
14	14	program. The report must:
15	15	(1) outline each factor of the reimbursement rate
16	16	methodology used by Medicaid managed care organizations and that
17	17	factor's weight in the methodology;
18	18	(2) explicitly illustrate the manner in which the
19	19	following affect current methodologies:
20	20	(A) previously adopted reimbursement rates;
21	21	(B) the cost of uncompensated care provided to
22	22	uninsured persons; and
23	23	(C) use of private insurance benefits;
24	24	(3) propose alternative reimbursement methodologies
25	25	that do not consider the items described by Subdivision (2) of this
26	26	subsection;
27	27	(4) evaluate how Medicaid provider reimbursement
28	28	rates affect access to care for Medicaid recipients, measured by
29	29	the number of providers each year who have stopped participating in
30	30	Medicaid since the commission began offering Medicaid services
31	31	through a managed care delivery model;
32	32	(5) compare provider participation in Medicaid by
33	33	region, particularly increases or decreases in the number of
34	34	participating providers since the commission began offering
35	35	Medicaid services through a managed care delivery model,
36	36	categorized by provider specialty and subspecialty;
37	37	(6) list, for each year since the commission began
38	38	offering Medicaid services through a managed care delivery model,
39	39	counties in which provider access standards have not been met;
40	40	(7) examine Medicaid provider incentive payment
41	41	programs and their effect on incentivizing providers to participate
42	42	or continue participating in Medicaid; and
43	43	(8) determine the feasibility and cost of
44	44	establishing:
45	45	(A) a minimum fee schedule for Medicaid providers
46	46	in counties where provider access standards are not being met; and
47	47	(B) a different reimbursement rate for classes of
48	48	providers who provide care in a county:
49	49	(i) located on an international border; or
50	50	(ii) with a Medicaid population at least 10
51	51	percent higher than the statewide average Medicaid population.
52	52	(c) Not later than December 1, 2020, the commission shall
53	53	prepare and submit to the legislature the report described by
54	54	Subsection (b) of this section. Notwithstanding that subsection,
55	55	the commission is not required to include in the report any
56	56	information the commission determines is proprietary.
57	57	SECTION 2. This Act takes effect September 1, 2019.