HBA-MPM H.B. 3010 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 3010 By: Hawley Insurance 4/22/2001 Introduced BACKGROUND AND PURPOSE The statewide rural health care system (RHCS) is the state-designated rural health care system created by the 75th Legislature in 1997. While the legislature appropriated no funding for the system during that session or the subsequent session in 1999, the system has coordinated with private sector program partners to create a model for a viable rural health care system. Allowing RHCS to participate in a voluntary Medicaid demonstration could enable RHCS to implement the model, which emphasizes preventive care, disease management, care coordination, and quality improvement and which could extend health care services to uninsured individuals who live in rural communities. House Bill 3010 authorizes the commissioner of health and human services to include RHCS in a voluntary pilot or demonstration program for Medicaid. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the commissioner of insurance in SECTION 4 (Article 20C.04, Insurance Code) of this bill. ANALYSIS House Bill 3010 amends the Insurance Code to authorize the commissioner of health and human services to include the statewide rural health care system (RHCS) in any voluntary pilot or demonstration program that seeks to evaluate the use of an insured model for beneficiaries of the medical assistance program (Medicaid) in a rural area that is not currently included in an existing Medicaid managed care pilot program area and that incorporates the principles of prevention and disease management, and studies the use of promotoras. The bill provides that RHCS is established and authorized to sponsor, arrange for or provide health care services that for programs in rural areas offered under the state child health plan (CHIP) or programs offered pursuant to the regional health care delivery system pilot program are not subject to a law that requires coverage or the offer of coverage of a health care service, benefit, or provision of services by a particular health care services provider or the use of a particular policy or contract form or of particular language in a policy or contract form. Additionally, RHCS is established to sponsor, arrange for or provide health care services that for programs in rural areas offered under Medicaid or under any state, county, or local government sponsored indigent care initiative or as part of any federal Medicare + Choice program are not subject to a law that requires coverage or the offer of coverage for the provision of services by a particular health care services provider. The bill provides that if RHCS seeks to sponsor, arrange, or provide such services under a private or commercial program, RHCS must meet each requirement imposed by current insurance law unless the commissioner of insurance grants by rule an exception to such requirements on the basis of distance, network adequacy, and scope of coverage. The bill removes provisions in current law that RHCS obtain a certificate of authority under the Texas Health Maintenance Organization Act. The bill removes the requirement that the governor appoint the members of the board of directors of RHCS (board). On a majority vote, the board is authorized to contract for management or support services in addition to administrative services, to contract with rather than hire consultants, attorneys, and other professionals, and to retain such other staff as necessary to implement the duties of RHCS. The bill also modifies the goals of RHCS. EFFECTIVE DATE The Act takes effect on the 91st day after adjournment.