Texas 2025 - 89th Regular

Texas Senate Bill SB2548

Filed

3/13/25

Out of Senate Committee

Voted on by Senate

Out of House Committee

Voted on by House

Governor Action

Bill Becomes Law

Caption

Relating to awarding contracts to managed care organizations under Medicaid and the child health plan program.

Impact

If enacted, SB2548 will alter how contracts are awarded by focusing not just on cost but also on the quality of care and organizational capability. This change is expected to enhance the quality of services provided to Medicaid recipients by ensuring that managed care organizations meet specific benchmarks and are held accountable for their performance. The outlined considerations for contract awarding could lead to improved healthcare outcomes for populations traditionally served by these organizations.

Summary

Senate Bill 2548 aims to reform the awarding of contracts to managed care organizations under the Medicaid and child health plan programs. It emphasizes the importance of continuity of care and requires that the awarding commission consider organizations with a strong regional presence and those that prioritize local healthcare providers. The bill specifies that preference should be given to organizations that are locally managed and operational, particularly in the South Texas service region where access to care has been a significant concern.

Contention

There are notable points of contention surrounding the bill, particularly regarding the extent to which local organizations can compete against larger, national providers. Supporters argue that prioritizing local organizations will lead to better care tailored to community needs, while opponents express concerns that such preferences might limit competition and the potential cost-effectiveness of services. Additionally, the provision for re-evaluation of bids may lead to legal complications, as organizations currently in the bidding process may challenge the changes mid-evaluation.

Texas Constitutional Statutes Affected

Government Code

Chapter 540. Medicaid Managed Care Program
- Section: 0204

Chapter 543. Clinical Initiatives To Improve Medicaid Quality Of Care And Cost-effectiveness
- Section: New Section

Chapter 2155. Purchasing: General Rules And Procedures
- Section: 144

Companion Bills

No companion bills found.

Previously Filed As

TX HB2401

Relating to certain contracting requirements under the Medicaid managed care delivery model.

TX SB651

Relating to the repeal of certain contracting requirements under the Medicaid managed care delivery model.

TX HB5018

Relating to certain payment recovery efforts by managed care organizations under Medicaid or the child health plan program.

TX HB1293

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB3286

Relating to prescription drug benefits under Medicaid and the child health plan program.

TX HB1283

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX SB1113

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX SB2201

Relating to certain prescription drug benefits under the Medicaid managed care program.

TX SB1239

Relating to reimbursement rates for eye health care services providers participating in the Medicaid managed care program.

TX HB3778