HBA-JLV S.B. 284 77(R)    BILL ANALYSIS


Office of House Bill AnalysisS.B. 284
By: Nelson
Public Health
5/15/2001
Engrossed



BACKGROUND AND PURPOSE 

The current Medicaid managed care reporting system can be onerous and
difficult to navigate due to the number of health plans involved in the
delivery of services.  Senate Bill 284 requires the Health and Human
Services Commission to study methods to streamline the reports required of
health care providers to reduce the administrative burden placed on
providers' practices, and to make recommendations to implement certain
practices.  The bill also requires relevant agencies to establish
interagency memoranda of understanding and a single audit instrument.  

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 284 amends the Government Code to require the Health and Human
Services Commission (HHSC) to: 

 _evaluate on-site inspection procedures of managed care organizations
contracting with the HHSC under the Medicaid managed care program; 

 _evaluate methods to streamline those procedures to assist HHSC in
determining necessary and effective quality control measures and required
data; 

 _evaluate methods to streamline reporting requirements for such managed
care organizations; and 
 
 _require such managed care organizations to evaluate reporting
requirements for health care providers to identify methods of reducing the
administrative burden placed on the providers. 

The bill requires HHSC to submit a report to the legislature not later than
November 1, 2002, regarding the evaluation of and methods for streamlining
on-site inspection procedures and reporting requirements for managed care
organizations and health care providers providing health care services to
recipients. The bill provides that the report must include recommendations
on which methods should be implemented and a schedule for implementation.
The bill provides that the provisions regarding evaluation of reporting
requirements and inspection procedures expire September 1, 2002. 

The bill provides that HHSC shall require a health and human services
agency implementing the Medicaid managed care program to provide to each
other health and human services agency implementing the Medicaid managed
care program information reported to that agency by a managed care
organization or health care provider providing services to recipients. 

 The bill requires the chief executive officers of HHSC, the Texas
Department of Insurance (TDI), and, if appropriate, health and human
services agencies, to execute and provide to all Medicaid health
maintenance organizations (HMOs) interagency memoranda of understanding
that maximize interagency coordination and eliminate existing and prevent
future duplicative monitoring, regulation, and enforcement policies and
processes. 

The bill requires HHSC and TDI to develop a single audit instrument to be
used by HHSC, health and human services agencies and their contractors, and
TDI and their contractors for regularly scheduled, comprehensive, on-site
readiness, performance, compliance, or other reviews, audits, and
examinations of Medicaid HMOs, and specify in detail the process the
agencies shall use to amend the single audit instrument. 

The bill requires HHSC and TDI to complete the interagency memoranda of
understanding and the single audit instrument not later than November 30,
2001. 

EFFECTIVE DATE

On passage, or if the Act does not receive the necessary vote, the Act
takes effect September 1, 2001.