Texas 2021 - 87th Regular

Texas Senate Bill SB191 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	87R2217 KFF-D
2	2	By: Johnson S.B. No. 191
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the use of social determinants of health in the Medicaid
8	8	managed care program.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 533.001, Government Code, is amended by
11	11	adding Subdivision (6-a) to read as follows:
12	12	(6-a) "Social determinants of health" means the
13	13	environmental conditions in which a person is born, lives, learns,
14	14	works, plays, worships, and ages that affect a range of health,
15	15	functional, and quality of life outcomes and risks.
16	16	SECTION 2. Section 533.003(a), Government Code, is amended
17	17	to read as follows:
18	18	(a) In awarding contracts to managed care organizations,
19	19	the commission shall:
20	20	(1) give preference to organizations that have
21	21	significant participation in the organization's provider network
22	22	from each health care provider in the region who has traditionally
23	23	provided care to Medicaid and charity care patients;
24	24	(2) give extra consideration to organizations that
25	25	agree to assure continuity of care for at least three months beyond
26	26	the period of Medicaid eligibility for recipients;
27	27	(3) consider the need to use different managed care
28	28	plans to meet the needs of different populations;
29	29	(4) consider the ability of organizations to process
30	30	Medicaid claims electronically; and
31	31	(5) give extra consideration to organizations that use
32	32	enriched data sets incorporating social determinants of health to
33	33	manage socially complex populations in a manner that achieves:
34	34	(A) cost savings through implementation of
35	35	appropriate interventions for those populations; and
36	36	(B) favorable health outcomes for those
37	37	populations by reducing preventable emergency room visits,
38	38	hospitalizations, and institutionalizations [in the initial
39	39	implementation of managed care in the South Texas service region,
40	40	give extra consideration to an organization that either:
41	41	[(A) is locally owned, managed, and operated, if
42	42	one exists; or
43	43	[(B) is in compliance with the requirements of
44	44	Section 533.004].
45	45	SECTION 3. Subchapter A, Chapter 533, Government Code, is
46	46	amended by adding Section 533.022 to read as follows:
47	47	Sec. 533.022. ANNUAL REPORT ON USE OF SOCIAL DETERMINANTS
48	48	OF HEALTH. Each Medicaid managed care organization that uses
49	49	enriched data sets described by Section 533.003(a)(5) shall submit
50	50	to the commission an annual report that assesses any cost savings
51	51	and favorable health outcomes achieved by using those data sets.
52	52	SECTION 4. Section 533.003(a), Government Code, as amended
53	53	by this Act, applies to a contract entered into or renewed on or
54	54	after the effective date of this Act. A contract entered into or
55	55	renewed before that date is governed by the law in effect on the
56	56	date the contract was entered into or renewed, and that law is
57	57	continued in effect for that purpose.
58	58	SECTION 5. If before implementing any provision of this Act
59	59	a state agency determines that a waiver or authorization from a
60	60	federal agency is necessary for implementation of that provision,
61	61	the agency affected by the provision shall request the waiver or
62	62	authorization and may delay implementing that provision until the
63	63	waiver or authorization is granted.
64	64	SECTION 6. This Act takes effect immediately if it receives
65	65	a vote of two-thirds of all the members elected to each house, as
66	66	provided by Section 39, Article III, Texas Constitution. If this
67	67	Act does not receive the vote necessary for immediate effect, this
68	68	Act takes effect September 1, 2021.