Texas 2019 - 86th Regular

Texas Senate Bill SB2040 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	86R32956 LED-D
2	1		By: Rodríguez S.B. No. 2040
3		-	(González of El Paso)
4		-	Substitute the following for S.B. No. 2040: No.
5	2
6	3
7	4		A BILL TO BE ENTITLED
8	5		AN ACT
9	6		relating to a report regarding Medicaid reimbursement rates and
10	7		access to care.
11	8		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	9		SECTION 1. (a) In this section, "commission" means the
13	10		Health and Human Services Commission.
14	11		(b) The commission shall prepare a written report regarding
15	12		provider reimbursement rates and access to care in the Medicaid
16		-	program. The commission shall collaborate with the medical care
17		-	advisory committee established under Section 32.022, Human
18		-	Resources Code, to develop and define the scope of the research for
19		-	the report. The report must:
20		-	(1) review the provider reimbursement rates for at
21		-	least 20 Medicaid-covered services;
22		-	(2) outline factors of the reimbursement rate
23		-	methodologies used by Medicaid managed care organizations;
24		-	(3) propose alternative reimbursement methodologies;
25		-	(4) evaluate the impact of Medicaid provider
26		-	reimbursement rates on access to care for Medicaid recipients;
	13	+	program. The report must:
	14	+	(1) outline each factor of the reimbursement rate
	15	+	methodology used by Medicaid managed care organizations and that
	16	+	factor's weight in the methodology;
	17	+	(2) explicitly illustrate the manner in which the
	18	+	following affect current methodologies:
	19	+	(A) previously adopted reimbursement rates;
	20	+	(B) the cost of uncompensated care provided to
	21	+	uninsured persons; and
	22	+	(C) use of private insurance benefits;
	23	+	(3) propose alternative reimbursement methodologies
	24	+	that do not consider the items described by Subdivision (2) of this
	25	+	subsection;
	26	+	(4) evaluate how Medicaid provider reimbursement
	27	+	rates affect access to care for Medicaid recipients, measured by
	28	+	the number of providers each year who have stopped participating in
	29	+	Medicaid since the commission began offering Medicaid services
	30	+	through a managed care delivery model;
27	31		(5) compare provider participation in Medicaid by
28	32		region, particularly increases or decreases in the number of
29		-	participating providers per year beginning with the state fiscal
30		-	year ending August 31, 2012, categorized by provider specialty and
31		-	subspecialty;
32		-	(6) list to the extent the information is available,
33		-	for each state fiscal quarter beginning with the first quarter of
34		-	the state fiscal year ending August 31, 2017:
35		-	(A) counties in which provider access standards
36		-	relating to distance have not been met; and
37		-	(B) counties in which provider access standards
38		-	relating to travel time have not been met;
39		-	(7) examine Medicaid directed provider payments and
40		-	their effect on incentivizing providers to participate or continue
41		-	participating in Medicaid, including:
42		-	(A) the uniform hospital rate increase program
43		-	described by 1 T.A.C. Section 353.1305;
44		-	(B) the quality incentive payment program
45		-	(QIPP); and
46		-	(C) the minimum reimbursement rate for nursing
47		-	facilities described by Section 533.00251, Government Code; and
	33	+	participating providers since the commission began offering
	34	+	Medicaid services through a managed care delivery model,
	35	+	categorized by provider specialty and subspecialty;
	36	+	(6) list, for each year since the commission began
	37	+	offering Medicaid services through a managed care delivery model,
	38	+	counties in which provider access standards have not been met;
	39	+	(7) examine Medicaid provider incentive payment
	40	+	programs and their effect on incentivizing providers to participate
	41	+	or continue participating in Medicaid; and
48	42		(8) determine the feasibility and cost of
49	43		establishing:
50	44		(A) a minimum fee schedule for Medicaid providers
51	45		in counties where provider access standards are not being met; and
52	46		(B) a different reimbursement rate for classes of
53	47		providers who provide care in a county:
54	48		(i) located on an international border; or
55	49		(ii) with a Medicaid population at least 10
56	50		percent higher than the statewide average Medicaid population.
57	51		(c) Not later than December 1, 2020, the commission shall
58	52		prepare and submit to the legislature the report described by
59	53		Subsection (b) of this section. Notwithstanding that subsection,
60	54		the commission is not required to include in the report any
61	55		information the commission determines is proprietary.
62	56		SECTION 2. This Act takes effect September 1, 2019.