Bill Text: TX HB1378 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to a report regarding Medicaid reimbursement rates, supplemental payment amounts, and access to care.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2023-03-03 - Referred to Human Services [HB1378 Detail]
Download: Texas-2023-HB1378-Introduced.html
88R3739 JG-D | ||
By: Ortega | H.B. No. 1378 |
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relating to a report regarding Medicaid reimbursement rates, | ||
supplemental payment amounts, and access to care. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. (a) In this section: | ||
(1) "Commission" means the Health and Human Services | ||
Commission. | ||
(2) "Supplemental payment amount" includes a payment | ||
made to a Medicaid provider under: | ||
(A) the Texas Healthcare Transformation and | ||
Quality Improvement Program waiver issued under Section 1115 of the | ||
Social Security Act (42 U.S.C. Section 1315); | ||
(B) another program operating under a waiver to | ||
the state Medicaid plan that provides a payment in excess of the | ||
Medicaid reimbursement rate; or | ||
(C) the Medicaid disproportionate share hospital | ||
payment program. | ||
(b) The commission shall prepare a written report on | ||
provider reimbursement rates, supplemental payment amounts paid to | ||
providers, and access to care under Medicaid. The commission shall | ||
collaborate with the state Medicaid managed care advisory committee | ||
to develop and define the scope of the research for the report. The | ||
report must: | ||
(1) review the provider reimbursement rates and | ||
supplemental payment amounts for at least 20 Medicaid-covered | ||
services; | ||
(2) outline factors of the reimbursement rate and | ||
supplemental payment amount methodologies used by Medicaid managed | ||
care organizations; | ||
(3) propose alternative reimbursement and | ||
supplemental payment amount methodologies; | ||
(4) evaluate the impact of Medicaid provider | ||
reimbursement rates and supplemental payment amounts on access to | ||
care for Medicaid recipients, including specifically evaluating | ||
the impact of Medicaid provider reimbursement rates and | ||
supplemental payment amounts for mental health and substance use | ||
disorder services on that access to care; | ||
(5) compare the reimbursement rates and supplemental | ||
payment amounts paid to mental health and substance use disorder | ||
providers to the rates and amounts paid to other Medicaid | ||
providers; | ||
(6) compare provider participation in Medicaid by | ||
region, particularly increases or decreases in the number of | ||
participating providers per year beginning with the state fiscal | ||
year ending August 31, 2012, categorized by provider specialty and | ||
subspecialty; | ||
(7) list to the extent the information is available, | ||
for each state fiscal quarter beginning with the first quarter of | ||
the state fiscal year ending August 31, 2017: | ||
(A) counties in which provider access standards | ||
relating to distance have not been met; and | ||
(B) counties in which provider access standards | ||
relating to travel time have not been met; | ||
(8) examine Medicaid directed provider payments and | ||
their effect on incentivizing providers to participate or continue | ||
participating in Medicaid, including: | ||
(A) the uniform hospital rate increase program | ||
described by 1 T.A.C. Section 353.1305; and | ||
(B) the quality incentive payment program | ||
(QIPP); and | ||
(9) determine the feasibility and cost of | ||
establishing: | ||
(A) a minimum fee schedule for Medicaid providers | ||
in counties where provider access standards are not being met; and | ||
(B) a different reimbursement rate or | ||
supplemental payment amount for classes of providers who provide | ||
care in a county: | ||
(i) located on an international border; or | ||
(ii) with a Medicaid population at least 10 | ||
percent higher than the statewide average Medicaid population. | ||
(c) Not later than December 1, 2024, the commission shall | ||
prepare and submit to the legislature the report described by | ||
Subsection (b) of this section. Notwithstanding that subsection, | ||
the commission is not required to include in the report any | ||
information the commission determines is proprietary. | ||
SECTION 2. This Act takes effect September 1, 2023. |