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4 Document(s) [ Subject: Preferred provider organizations ]

Committee:	Senate Managed Care and Consumer Protections, Interim
Title:	Interim report
Library Catalog Title:	A report to the 75th Legislature .
Subjects:	Consumer protection | Emergency medical services | Health maintenance organizations | Hospital emergency rooms | Managed care | Patients' rights | Preferred provider organizations | Quality of care |
Library Call Number:	L1836.74 m311r
Session:	74th R.S. (1995)
Online version:	View report [168 pages  File size: 7,079 kb]
Charges:	This report should address the charges below.
1.	Evaluate the ability of managed care organizations to provide adequate access to medical care. Examine Health Maintenance Organization (HMO) licensing standards as they relate to physician/patient rations, specialty physician/patient ratios, scope of medical coverage and geographic coverage requirements.
2.	Study the incidence of emergency room utilization and the standards used to establish eligibility by an HMO for emergency room services.
3.	Evaluate the requirements of an HMO to have adequate and effective consumer appeals processes in place for denied services, prescription drugs, etc.
4.	Evaluate the standards of consumer education, in terms of availability and scope, and determine the extent to which they are, or should, be governed by regulation or statue.
5.	Assess the process by which "medical necessity" is determined by an HMO, who may participate in establishing the criteria, if the process is governed by current or pending regulations and if the standards need enhancement.
6.	The Interim Committee should study each of the above items and make recommendations based on its findings. In making its recommendations, the Interim Committee should consider whether modifications need to be addressed through state agency rule making authority or statutorily by the Legislature.
Committee:	House Human Services
Title:	Interim Report
Library Catalog Title:	Interim report of the Committee on Human Services, Texas House of Representatives to the Seventieth Legislative Session, 1986.
Subjects:	Assisted living facilities | Child care | Child Protective Services | Criminal records | Long-term care | Medicaid | Medical reimbursements | Medicare | Mental health services | Nursing homes | Poverty | Preferred provider organizations | Privatization | Senior citizens | State employee turnover | Teenage pregnancy | Welfare | Welfare-to-work |
Library Call Number:	L1836.69 h88
Session:	69th R.S. (1985)
Online version:	View report [178 pages  File size: 9,803 kb]
Charges:	This report should address the charges below.
1.	To study the Aid to Families with Dependent Children Program (AFDC), including the problems of needy children and their families, the various employment, training and education programs, and other options designed to help Texas families become self-supporting.
2.	To study the problems encountered by the elderly in gaining access to appropriate post-hospital health care services, including skilled nursing and custodial services.
3.	To study the Child Protective Services Program of the Department of Human Services regarding case workloads and staffing requirements.
4.	To study the implementation of criminal background check legislation for child-care workers including the use of federal funds for caregiver training.
5.	To study continuing care communities and other options for the well-elderly.
6.	To study the problems of preventing unwanted teenage pregnancy, preventing poor parenting by teenagers, and preventing unemployment and poverty in teen-headed families.
7.	To study the advantages and disadvantages of the preferred provider insurance plan, with particular emphasis on consideration of quality of services, access to services, cost of care rendered, the effect on existing physician-patient relationships, and a proposed legislative/regulatory structure for such medical care delivery and financing arrangements; in conjunction with Insurance and Public Health Committees.
8.	To study the utilization of and potential for further development of privatization of care for the mentally ill and mentally retarded in the State, in conjunction with Appropriations and Law Enforcement committees.
9.	To study the impact on Medicare-Medicaid and associated state health and welfare costs of the elimination of the certificate of need process in Texas.
Committee:	House Insurance
Title:	Interim Report
Library Catalog Title:	Interim report of the Insurance Committee, Texas House of Representatives, 69th Legislature.
Subjects:	Birth defects | Children's health insurance | Environmental cleanup | Hazardous substances | Health insurance | Liability insurance | Preferred provider organizations | Property insurance | Texas Catastrophic Property Insurance Association | Vehicle insurance |
Library Call Number:	L1836.69 in7
Session:	69th R.S. (1985)
Online version:	View report [55 pages  File size: 1,308 kb]
Charges:	This report should address the charges below.
1.	Monitor all activities and have budget oversight responsibilities for those agencies, boards and commissions as listed in Rule 3, Section 17.
2.	Study the advantages and disadvantages of the preferred provider organization (PPO) health insurance plan, with particular emphasis on consideration of quality of services, access to services, cost of care rendered, the effect on existing physician-patient relationships, and a proposed legislative/regulatory structure for such medical care delivery and financing arrangements; in conjunction with Human Services and Public Health Committees.
3.	Study the need in Texas to make available to newborn infants accident and sickness insurance benefits covering sickness or illness including congenital benefits.
4.	Study possible reforms in the State's mandatory liability insurance laws.
5.	Study the problems and financial soundness of the CAT (catastrophic) insurance pool and the potential liability to the State of maintaining the present system.
6.	Study the feasibility of mandatory extended care coverage for head injury victims after that victim has left the initial care facility of a licensed hospital.
7.	Study the availability of and rising costs of liability insurance in Texas.
8.	Study liability and insurability problems being faced by the engineering and construction companies who seek to participate in the cleanup of hazardous waste disposal sites in Texas.
Committee:	House Public Health
Title:	Interim Report
Library Catalog Title:	Report of the Committee on Public Health.
Subjects:	Health insurance | Mental Health and Mental Retardation, Texas Department of | Mental health services | Mentally disabled persons | Preferred provider organizations |
Library Call Number:	L1836.69 h349
Session:	69th R.S. (1985)
Online version:	View report [24 pages  File size: 694 kb]
Charges:	This report should address the charges below.
1.	To study the development and administration of master plans for mental health and mental retardation by the Department of Mental Health and Mental Retardations (MHMR).
2.	To study the advantages and disadvantages of the preferred provider organization (PPO) insurance plan, with particular emphasis on consideration of quality of services, access to services, cost of care rendered, the effect on existing physician-patient relationships, and a proposed legislative/regulatory structure for such medical care delivery and financing arrangements; in conjunction with Insurance and Human Services Committees.
3.	To study the statewide need for expanded respite care programs for the mentally retarded.

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