HBA-NMO H.B. 1388 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1388
By: Van de Putte
Public Health
3/23/99
Introduced



BACKGROUND AND PURPOSE 

Currently, this state spends Medicaid dollars on special outreach and case
management services to address issues relating to the implementation of
managed care under Medicaid. Some assert that Medicaid, as a source of
public funding, has never been tapped for its job-creation potential in the
low-income community.  H.B. 1388 requires the commissioner of public health
to establish a neighborhood-based peer health outreach and education pilot
program to address health care issues, including those concerning managed
care.  

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis rulemaking authority
is expressly delegated to the commissioner of public health in SECTIONS 3
and 4 of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  DEFINITIONS.  Defines "commissioner" as the commissioner of
public health; "local pilot program" as a project operated in an area of
this state to implement the program; "medicaid managed care organization"
as a managed care organization that is operating a portion of the Medicaid
managed care program under Chapter 533 (Implementation of Medicaid Managed
Care Program), Government Code; and "program" as the neighborhood-based
peer health outreach and education pilot program established under this
Act. 

SECTION 2.  PEER HEALTH OUTREACH AND EDUCATION PILOT PROGRAM.  Requires the
commissioner to establish a neighborhood-based peer health outreach and
education program to educate Medicaid recipients (recipients) on the
appropriate use of health care resources, promote regular use of preventive
care services by recipients, encourage recipients to develop a basic family
preventive health plan, and encourage and support Medicaid recipients in
keeping up with health care appointments and complying with the
instructions of health care providers. 

SECTION 3.  OPERATION OF PROGRAM.  Authorizes the commissioner, subject to
appropriation, to provide grants to local pilot projects in not more than
five areas in the state to provide partial support for the operation of the
pilot program in that area.  Authorizes the commissioner to adopt rules
relating to application for grants under this section and the use of funds
granted to local pilot programs. 

SECTION 4.  CONFIDENTIALITY.  Authorizes the commissioner, subject to
federal law or regulation, to authorize a local pilot program to obtain
confidential information from certain health related state agencies,
Medicaid contractors,  and a health care providers; and to use the
information to conduct the peer outreach and education pilot program in the
area.  Provides that information obtained by a local pilot project is
limited to commissioner determination.  Authorizes the information obtained
to include the recipient's name, address, telephone number, date of birth,
Medicaid managed care plan and primary care provider, and appointment
scheduling information. Authorizes the information obtained to be used only
for purposes for which it was obtained and prohibits the local pilot
project from releasing the information to any entity other than those from
among which the information was obtained.  Authorizes the commissioner to
adopt rules that impose additional restrictions on the use of the
information. 

 SECTION 5.  EVALUATION AND REPORT.  Requires the commissioner, not later
than December 15, 2000, to submit a report to the governor, lieutenant
governor, and speaker of the house of representatives that evaluates the
effectiveness and cost-effectiveness of the program.  Provides that the
report must include the commissioner's recommendations with respect to
providing outreach and education services to recipients through regional
services contracts that are compensated on a capitated basis and that are
implemented by entities other than Medicaid managed care organizations. 

SECTION  6.  TERMINATION; EXPIRATION.  Provides that this Act expires
September 1, 2001. 

SECTION 7.Emergency clause.
  Effective date: upon passage.