HBA-MPM C.S.H.B. 2236 76(R)BILL ANALYSIS


Office of House Bill AnalysisC.S.H.B. 2236
By: Gray
Public Health
34/6/1999
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

The University of Texas Medical Branch (UTMB) at Galveston has for more
than 100 years provided health care for individuals who have no insurance
and cannot pay for their health care.  Last year, UTMB served uninsured
children and adults from 235 Texas counties, at a cost of more than $142
million in charity care.  State and federal changes to Medicaid and
Medicare reimbursement resulted in decreases in reimbursement to UTMB of
more than $28 million, thereby hindering the facility's ability to care for
indigent Texans.   

C.S.H.B. 2236 allows UTMB to contract with certain state agencies,
including the Texas Department of Health and the Texas Department of Human
Services, to be one of the HMOs to provide managed care services to certain
populations of Texans. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 533.004(a), Government Code, to specify that in
providing health care services through Medicaid managed care to recipients
in a health care service region, the Health and Human Services Commission
is required to contract with a managed care organization, rather than at
least one managed care organization,  in that region that meets certain
specifications. Includes among a list of specifications that a managed care
organization holds a certificate of authority under Article 20A.05
(Issuance of Certificate of Authority), Insurance Code, and that is
certified under Section 5.01(a), Article 4495(b), V.T.C.S. (Medical
Practice Act), and that it is created by the University of Texas Medical
Branch at Galveston.  Describes for the purposes of a managed care
organization described by this section:  "health care service region" or
"region." Redesignates existing Subdivisions (1)-(3) to Paragraphs (A)-(C),
and existing Paragraphs (A) and (B) to Subparagraphs (i) and (ii),
respectively. 

SECTION 2.Emergency clause.
  Effective date: upon passage.

COMPARISON OF ORIGINAL TO SUBSTITUTE

C.S.H.B. 2236 modifies the original bill in SECTION 1 (Section 533.004,
Government Code),  by requiring that the Health and Human Services
Commission contract with any managed care organization in that region,
rather than "a managed care organization," in providing health care
services through Medicaid managed care to recipients in a health care
service region, to meet certain requirements.  Additionally, this
substitute modifies the original by including in proposed Subdivision
533.004(a)(2) among a list of specifications that a managed care
organization hold a certificate of authority under Article 20A.05 (Issuance
of Certificate of Authority), Insurance Code, rather than Article 21.52F
(Right to Select Practitioner Under Health and Accident Policies),
Insurance Code, and that meets certain certification requirements.
Additionally, the substitute also adds new Subsection (e) to include the
definitions of "health care service region" or "region" for purposes of
this section.