HBA-DMH H.B. 2470 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 2470
By: Chavez
Public Health
3/13/2001
Introduced



BACKGROUND AND PURPOSE 

Residents in the Texas-Mexico border region suffer from inadequate medical
services compared with most Texans.  Physician to patient ratios are lowest
along the border region an in rural areas and inner cities. In February
2000, the Health and Human Services Commission (HHSC) convened the Border
Rate Work Group (work group) to study and recommend solutions regarding
Medicaid and the state child health plan (CHIP) reimbursement rates along
the Texas-Mexico border.  The work group concluded that a lack of access to
health care services along the border has reduced the utilization rates of
health care services in the region, that the border region receives
disproportionately low reimbursement as a result of low utilization rates,
and that Medicaid and CHIP capitation rates do not reflect the current
health care environment since they are based on past fee for service
reimbursement rates.  The report also found that lower revenue provides a
disincentive for health care providers to locate and remain in the border
region. The work group recommended increasing Medicaid and CHIP
reimbursement rates in this region to recruit more doctors and increase
access to care.  House Bill 2470 requires HHSC to increase Medicaid and
CHIP reimbursement rates for recipients in the Texas-Mexico border region
to an adjusted statewide average and provides physicians with a 10 percent
bonus for providing services in the region. 

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 2470 amends the Government Code to require the commissioner of
health and human services (commissioner) to appoint an advisory committee
(committee) to develop a strategic plan for eliminating the disparities
between the Texas-Mexico border region and other areas of the state in
certain Medicaid and state child health plan (CHIP) rates and expenditures.
The bill sets forth provisions for the appointment, administration, and
operation of the committee.  The bill requires the committee to perform the
research necessary to analyze and compare the rates and expenditures, and
produce a report based on the results of that analysis and comparison.  The
bill requires the committee to make recommendations for addressing the
problems created by disparities documented in the report.  

With advice from committee, the bill requires the  Health and Human Service
Commission (HHSC) to ensure that: 

_the disparities in rates and expenditures are eliminated as soon as
practicable so that the rates and expenditures in the Texas-Mexico border
region equal those statewide; 

_a physician providing a service to a Medicaid recipient in the
Texas-Mexico border region receives a bonus in the amount of 10 percent of
the reimbursement customarily provided to a physician providing that
services in another region of the state. 


 The bill requires HHSC to exclude data from the Texas-Mexico border region
in determining statewide average rates and expenditures.  With advice from
the committee and other appropriate groups, the bill authorizes HHSC to
vary the amount of any rate increases for professional services according
to the type of service provided.  The bill requires HHSC to develop
mechanisms to pass any rate increase directly to providers. 

The bill requires HHSC to contract with a public university to:

_measure changes occurring from September 1, 2001, to August 31, 2004, in
the number of health care providers participating in the Medicaid or CHIP
in the Texas-Mexico border region and resulting effects on consumer access
to health care and consumer utilization; 
 
_determine any effects of the changes in rates and expenditures; and

_submit a report to the legislature, not later than December 1, 2004.

The bill provides that these provisions expire September 1, 2011, and that
the changes in rates and expenditures must be initiated by September 1,
2002. 

EFFECTIVE DATE

September 1, 2001.