Texas 2023 - 88th Regular

Texas House Bill HB1378 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R3739 JG-D
2	2	By: Ortega H.B. No. 1378
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a report regarding Medicaid reimbursement rates,
8	8	supplemental payment amounts, and access to care.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. (a) In this section:
11	11	(1) "Commission" means the Health and Human Services
12	12	Commission.
13	13	(2) "Supplemental payment amount" includes a payment
14	14	made to a Medicaid provider under:
15	15	(A) the Texas Healthcare Transformation and
16	16	Quality Improvement Program waiver issued under Section 1115 of the
17	17	Social Security Act (42 U.S.C. Section 1315);
18	18	(B) another program operating under a waiver to
19	19	the state Medicaid plan that provides a payment in excess of the
20	20	Medicaid reimbursement rate; or
21	21	(C) the Medicaid disproportionate share hospital
22	22	payment program.
23	23	(b) The commission shall prepare a written report on
24	24	provider reimbursement rates, supplemental payment amounts paid to
25	25	providers, and access to care under Medicaid. The commission shall
26	26	collaborate with the state Medicaid managed care advisory committee
27	27	to develop and define the scope of the research for the report. The
28	28	report must:
29	29	(1) review the provider reimbursement rates and
30	30	supplemental payment amounts for at least 20 Medicaid-covered
31	31	services;
32	32	(2) outline factors of the reimbursement rate and
33	33	supplemental payment amount methodologies used by Medicaid managed
34	34	care organizations;
35	35	(3) propose alternative reimbursement and
36	36	supplemental payment amount methodologies;
37	37	(4) evaluate the impact of Medicaid provider
38	38	reimbursement rates and supplemental payment amounts on access to
39	39	care for Medicaid recipients, including specifically evaluating
40	40	the impact of Medicaid provider reimbursement rates and
41	41	supplemental payment amounts for mental health and substance use
42	42	disorder services on that access to care;
43	43	(5) compare the reimbursement rates and supplemental
44	44	payment amounts paid to mental health and substance use disorder
45	45	providers to the rates and amounts paid to other Medicaid
46	46	providers;
47	47	(6) compare provider participation in Medicaid by
48	48	region, particularly increases or decreases in the number of
49	49	participating providers per year beginning with the state fiscal
50	50	year ending August 31, 2012, categorized by provider specialty and
51	51	subspecialty;
52	52	(7) list to the extent the information is available,
53	53	for each state fiscal quarter beginning with the first quarter of
54	54	the state fiscal year ending August 31, 2017:
55	55	(A) counties in which provider access standards
56	56	relating to distance have not been met; and
57	57	(B) counties in which provider access standards
58	58	relating to travel time have not been met;
59	59	(8) examine Medicaid directed provider payments and
60	60	their effect on incentivizing providers to participate or continue
61	61	participating in Medicaid, including:
62	62	(A) the uniform hospital rate increase program
63	63	described by 1 T.A.C. Section 353.1305; and
64	64	(B) the quality incentive payment program
65	65	(QIPP); and
66	66	(9) determine the feasibility and cost of
67	67	establishing:
68	68	(A) a minimum fee schedule for Medicaid providers
69	69	in counties where provider access standards are not being met; and
70	70	(B) a different reimbursement rate or
71	71	supplemental payment amount for classes of providers who provide
72	72	care in a county:
73	73	(i) located on an international border; or
74	74	(ii) with a Medicaid population at least 10
75	75	percent higher than the statewide average Medicaid population.
76	76	(c) Not later than December 1, 2024, the commission shall
77	77	prepare and submit to the legislature the report described by
78	78	Subsection (b) of this section. Notwithstanding that subsection,
79	79	the commission is not required to include in the report any
80	80	information the commission determines is proprietary.
81	81	SECTION 2. This Act takes effect September 1, 2023.