Texas 2021 - 87th Regular

Texas Senate Bill SB171 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	By: Blanco, et al. S.B. No. 171
	1	+	By: Blanco, Hinojosa, West S.B. No. 171
	2	+	(In the Senate - Filed November 10, 2020; March 3, 2021,
	3	+	read first time and referred to Committee on Health & Human
	4	+	Services; April 29, 2021, reported adversely, with favorable
	5	+	Committee Substitute by the following vote: Yeas 9, Nays 0;
	6	+	April 29, 2021, sent to printer.)
	7	+	Click here to see the committee vote
	8	+	COMMITTEE SUBSTITUTE FOR S.B. No. 171 By: Blanco
2	9
3	10
4	11		A BILL TO BE ENTITLED
5	12		AN ACT
6	13		relating to a report regarding Medicaid reimbursement rates,
7	14		supplemental payment amounts, and access to care.
8	15		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	16		SECTION 1. (a) In this section:
10	17		(1) "Commission" means the Health and Human Services
11	18		Commission.
12	19		(2) "Supplemental payment amount" includes a payment
13	20		made to a Medicaid provider under the Texas Healthcare
14	21		Transformation and Quality Improvement Program waiver issued under
15	22		Section 1115 of the Social Security Act (42 U.S.C. Section 1315),
16	23		another program operating under a waiver to the state Medicaid plan
17	24		that provides a payment in excess of the Medicaid reimbursement
18	25		rate, or the Medicaid disproportionate share hospital payment
19	26		program.
20	27		(b) The commission shall prepare a written report regarding
21	28		provider reimbursement rates, supplemental payment amounts paid to
22	29		providers, and access to care under Medicaid. The commission shall
23	30		collaborate with the state Medicaid managed care advisory committee
24	31		to develop and define the scope of the research for the report. The
25	32		report must:
26	33		(1) review the provider reimbursement rates and
27	34		supplemental payment amounts for at least 20 Medicaid-covered
28	35		services;
29	36		(2) outline factors of the reimbursement rate and
30	37		supplemental payment amount methodologies used by Medicaid managed
31	38		care organizations;
32	39		(3) propose alternative reimbursement and
33	40		supplemental payment amount methodologies;
34	41		(4) evaluate the impact of Medicaid provider
35	42		reimbursement rates and supplemental payment amounts on access to
36	43		care for Medicaid recipients, including specifically evaluating
37	44		the impact of Medicaid provider reimbursement rates and
38	45		supplemental payment amounts for mental health and substance use
39	46		disorder services on that access to care;
40	47		(5) compare the reimbursement rates and supplemental
41	48		payment amounts paid to mental health and substance use disorder
42	49		providers to the rates and amounts paid to other Medicaid
43	50		providers;
44	51		(6) compare provider participation in Medicaid by
45	52		region, particularly increases or decreases in the number of
46	53		participating providers per year beginning with the state fiscal
47	54		year ending August 31, 2012, categorized by provider specialty and
48	55		subspecialty;
49	56		(7) list to the extent the information is available,
50	57		for each state fiscal quarter beginning with the first quarter of
51	58		the state fiscal year ending August 31, 2017:
52	59		(A) counties in which provider access standards
53	60		relating to distance have not been met; and
54	61		(B) counties in which provider access standards
55	62		relating to travel time have not been met;
56	63		(8) examine Medicaid directed provider payments and
57	64		their effect on incentivizing providers to participate or continue
58	65		participating in Medicaid, including:
59	66		(A) the uniform hospital rate increase program
60	67		described by 1 T.A.C. Section 353.1305;
61	68		(B) the quality incentive payment program
62	69		(QIPP); and
63	70		(C) the minimum reimbursement rate for nursing
64	71		facilities described by Section 533.00251, Government Code; and
65	72		(9) determine the feasibility and cost of
66	73		establishing:
67	74		(A) a minimum fee schedule for Medicaid providers
68	75		in counties where provider access standards are not being met; and
69	76		(B) a different reimbursement rate or
70	77		supplemental payment amount for classes of providers who provide
71	78		care in a county:
72	79		(i) located on an international border; or
73	80		(ii) with a Medicaid population at least 10
74	81		percent higher than the statewide average Medicaid population.
75	82		(c) Not later than December 1, 2022, the commission shall
76	83		prepare and submit to the legislature the report described by
77	84		Subsection (b) of this section. Notwithstanding that subsection,
78	85		the commission is not required to include in the report any
79	86		information the commission determines is proprietary.
80	87		SECTION 2. This Act takes effect September 1, 2021.
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