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.