HBA-CCH H.B. 1001 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1001
By: Naishtat
Human Services
3/23/2001
Introduced



BACKGROUND AND PURPOSE 

The House Human Services Committee reports that both industry
representatives and nursing home resident advocacy groups point to the
methodology for calculating Medicaid reimbursement rates as an underlying
cause for much of the nursing home industry's problems.  The current
methodology may not accurately reflect all justifiably reimbursable costs
of doing business.  In addition, the current Texas Index for Level of
Effort (TILE) reimbursement system does not always reflect the true
resource needs of residents.  For example, facilities generally receive the
lowest rate of reimbursement for patients with Alzheimer's or related
dementia even though caring for these patients demands more staff time.
Furthermore, the reimbursement methodology needs to provide incentives for
increased direct care spending.  House Bill 1001 requires the Health and
Human Services Commission and the Department of Human Services to review
the base reimbursement methodology for nursing home care.  

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. 

ANALYSIS

House Bill 1001 requires the Health and Human Services Commission (HHSC) in
conjunction with the Texas Department of Human Services (DHS) to evaluate
the methodology and rates used for determining Medicaid reimbursement rates
for nursing facilities.  H.B. 1001 requires HHSC and DHS to explore methods
to adjust the reimbursement rate to account for sudden increases in
liability insurance rates and other legitimate costs of doing business, to
evaluate the effectiveness of the Medicaid nursing facility reimbursement
rate methodology in providing incentives for increased direct staffing, and
to examine the possibility of adding incentives to improve the care, diet,
and quality of life for facility residents.  The bill requires HHSC, in
conjunction with DHS, to evaluate the Texas Index for Level of Effort
classification system to determine whether the system accurately accounts
for the care needs of patients with dementia, including those with
Alzheimer's disease.  The bill also requires HHSC to report the results of
the evaluations to the governor, lieutenant governor, and the speaker of
the house of representatives no later than December 1, 2002. 

EFFECTIVE DATE

September 1, 2001.