Texas Senate Bill SB1094

Texas 2019 - 86th Regular

Caption

Relating to the delivery of Medicaid benefits to certain medically dependent children with private health benefits coverage.

Impact

The enactment of SB1094 is anticipated to have a significant impact on state Medicaid regulations, particularly those concerning how Medicaid interacts with private health benefits. It elevates the priority of individualized care for children with disabilities by tweaking existing Medicaid structures to allow for better coordination between services, ensuring that families can make use of their private options while still receiving needed Medicaid support. Furthermore, the bill requires a health home be designated for recipients to improve their care management.

Summary

SB1094 addresses the delivery of Medicaid benefits specifically for certain medically dependent children who also have private health insurance coverage. The bill mandates that the Texas Commission will provide medical assistance under a fee-for-service delivery model for these children, effectively ensuring that Medicaid acts as a secondary payer after the private insurance. This approach is aimed at better serving the needs of medically dependent children, ensuring they have timely access to necessary health care treatments without being financially burdened by overlapping obligations of both Medicaid and private insurance.

Contention

There are notable discussions around the implications of this bill, particularly on how it influences costs associated with Medicaid services. Supporters argue it could result in cost efficiency and improved health outcomes through better service coordination. However, some opponents express concerns over potential increases in bureaucratic complexity and whether shifting to a fee-for-service model could introduce additional administrative hurdles for families advocating for their children's needs. These variations in perspectives indicate an ongoing dialogue regarding Medicaid reform and service delivery improvements.