HBA-LJP S.B. 1299 77(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 1299 By: Lucio Public Health 5/17/2001 Committee Report (Amended) BACKGROUND AND PURPOSE Current Medicaid and child health plan program (CHIP) reimbursement rates are often below the cost of providing services. Some providers place a limit on the number of Medicaid or CHIP patients the providers accept based on the number of estimated private pay patients to offset the financial loss incurred by the low Medicaid and CHIP reimbursement rates. However, in areas with a disproportionately high number of Medicaid and CHIP patients, providers may be unable to offset the financial loss. Also, the method of determining reimbursement rates often fails to take into account such things as the adverse effects of low cost structures in certain areas and issues of inadequate access to care. Senate Bill 1299 establishes a task force to examine and evaluate rate-setting methodologies for the Medicaid and CHIP program. 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 Senate Bill 1299 amends the Government Code to require the commissioner of health and human services (commissioner) to appoint a task force to examine and evaluate rate-setting methodologies for the Medicaid program and the child health plan program (CHIP). The bill requires the task force to produce a report no later than December 1, 2002, based on the results of the evaluation and deliver the report to the commissioner and the legislature. The report must include recommendations on ways to improve the ratesetting methodologies. The bill sets forth the relevant information that the task force is to consider in preparing the report. The bill requires the task force to continue to monitor the information evaluated in the report and any changes made in the rate-setting methodologies for the Medicaid and CHIP programs and to submit another report with any additional recommendations to the commissioner and the legislature not later than December 1, 2004. The bill sets forth the composition, compensation, and the reimbursement of the 11 member task force. The bill requires the Health and Human Services Commission to provide administrative support and resources to the task force as necessary and provides that the task force is not subject to provisions relating to state advisory committees. The bill requires the task force to seek technical assistance, if needed, from the federal Health Care Financing Administration. The provisions of this bill expire September 1, 2005. EFFECTIVE DATE September 1, 2001. EXPLANATION OF AMENDMENTS Committee Amendment No. 1 adds to the composition of the task force representatives of one or more health maintenance organizations that arrange health care services for members in Medicaid managed care, the child health plan program (CHIP), or both and provides that experience in both Medicaid managed care and CHIP be represented on the task force. The amendment also adds one or more public representatives to the task force.