HBA-DMH H.C.R. 214 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.C.R. 214
By: Chavez
Public Health
4/23/2001
Committee Report (Amended)



BACKGROUND AND PURPOSE 

Currently, the federal share of the state's Medicaid costs, also referred
to as the Federal Medical Assistance Percentage (FMAP), is calculated by
comparing our state's per capita income with the per capita income of other
states.  Unfortunately, because of our geographic size the prosperity of
certain regions masks the needs of other regions. The Texas-Mexico border
region suffers from an inadequate medical infrastructure that has led to
disparities in access to health care.  Historically, the Texas-Mexico
border region has had high patient-to-physician ratios, resulting in
reduced utilization rates.  The availability of medical care in Mexico may
also be a factor in lower utilization rates for the region.  A low
utilization rate along the border creates a distorted assessment of the
actual demand for services and inappropriately lowers the capitated
reimbursement rates for Medicaid and the state child health plan (CHIP).
Lower reimbursement rates create a disincentive for healthcare providers to
locate and provide services to Medicaid and CHIP recipients in the region.
Establishing a separate FMAP for the region would allow current state
Medicaid funding in the region to draw down additional federal funds to
help eliminate the disparity.  House Concurrent Resolution 214 urges the
Congress of the United States to establish a separate FMAP for the
Texas-Mexico border region. 

RULEMAKING AUTHORITY

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

ANALYSIS

House Concurrent Resolution 214 urges the Congress of the United States to
establish a separate Federal Medical Assistance Percentage for the
Texas-Mexico border region. 

EXPLANATION OF AMENDMENTS

Committee Amendment No. 1 adds the word "provider" to the provisions
relating to average per-recipient provided reimbursement.