Texas Senate Bill SB791

Texas 2019 - 86th Regular

Caption

Relating to the accreditation of and a recipient's enrollment in a Medicaid managed care plan.

Impact

The changes brought about by SB791 will significantly influence how managed care organizations operate within Texas. By establishing accreditation as a prerequisite for contracts, the state seeks to align provider performance with national quality benchmarks. Additionally, the bill includes provisions to facilitate the enrollment of recipients, particularly vulnerable populations such as pregnant women and newborns, into suitable managed care plans. The automatic enrollment process indicates an effort to simplify the access to necessary health services, hence improving overall health care delivery.

Summary

SB791 aims to enhance the accreditation process for Medicaid managed care plans in Texas. The bill stipulates that the Texas Health and Human Services Commission can only contract with managed care organizations that are accredited by recognized national bodies. This requirement is designed to ensure that the health care services provided to Medicaid recipients meet specific quality standards, thereby aiming to improve outcomes for enrollees in the program. The legislation reflects a growing emphasis on accountability and standardization in the health care sector, particularly within state-managed programs.

Contention

While the intent of SB791 focuses on improving quality in Medicaid care, there may be points of contention regarding how these accreditation standards are set and enforced. Stakeholders might debate the potential implications for smaller or new managed care organizations that may struggle to meet stringent accreditation requirements. Furthermore, the bill's expansion of enrollment protocols could prompt discussions on the adequacy of resources to support the influx of new recipients as well as the impact on existing healthcare providers and facilities.