87R1834 JG-D
By: Blanco S.B. No. 171
A BILL TO BE ENTITLED
AN ACT
relating to a report regarding Medicaid reimbursement rates and
access to care.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. (a) In this section, "commission" means the
Health and Human Services Commission.
(b) The commission shall prepare a written report regarding
provider reimbursement rates and access to care under Medicaid.
The commission shall collaborate with the medical care advisory
committee established under Section 32.022, Human Resources Code,
to develop and define the scope of the research for the report. The
report must:
(1) review the provider reimbursement rates for at
least 20 Medicaid-covered services;
(2) outline factors of the reimbursement rate
methodologies used by Medicaid managed care organizations;
(3) propose alternative reimbursement methodologies;
(4) evaluate the impact of Medicaid provider
reimbursement rates on access to care for Medicaid recipients;
(5) compare provider participation in Medicaid by
region, particularly increases or decreases in the number of
participating providers per year beginning with the state fiscal
year ending August 31, 2012, categorized by provider specialty and
subspecialty;
(6) list to the extent the information is available,
for each state fiscal quarter beginning with the first quarter of
the state fiscal year ending August 31, 2017:
(A) counties in which provider access standards
relating to distance have not been met; and
(B) counties in which provider access standards
relating to travel time have not been met;
(7) examine Medicaid directed provider payments and
their effect on incentivizing providers to participate or continue
participating in Medicaid, including:
(A) the uniform hospital rate increase program
described by 1 T.A.C. Section 353.1305;
(B) the quality incentive payment program
(QIPP); and
(C) the minimum reimbursement rate for nursing
facilities described by Section 533.00251, Government Code; and
(8) determine the feasibility and cost of
establishing:
(A) a minimum fee schedule for Medicaid providers
in counties where provider access standards are not being met; and
(B) a different reimbursement rate for classes of
providers who provide care in a county:
(i) located on an international border; or
(ii) with a Medicaid population at least 10
percent higher than the statewide average Medicaid population.
(c) Not later than December 1, 2022, the commission shall
prepare and submit to the legislature the report described by
Subsection (b) of this section. Notwithstanding that subsection,
the commission is not required to include in the report any
information the commission determines is proprietary.
SECTION 2. This Act takes effect September 1, 2021.