Bill Text: TX HB2349 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to transparency in the rate-setting processes for the Medicaid managed care and child health plan programs.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-03-06 - Referred to Human Services [HB2349 Detail]
Download: Texas-2019-HB2349-Introduced.html
86R13483 LED-D | ||
By: Muñoz, Jr. | H.B. No. 2349 |
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relating to transparency in the rate-setting processes for the | ||
Medicaid managed care and child health plan programs. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter A, Chapter 533, Government Code, is | ||
amended by adding Section 533.01314 to read as follows: | ||
Sec. 533.01314. TRANSPARENCY OF PREMIUM PAYMENT | ||
RATE-SETTING PROCESS FOR MEDICAID MANAGED CARE PROGRAM. (a) The | ||
commission shall ensure the transparency of the premium payment | ||
rate-setting process for the Medicaid managed care program by | ||
publishing actuarial reports: | ||
(1) in a format that allows for tracing data and | ||
formulas across attachments, exhibits, and examples; and | ||
(2) that clearly identify and describe: | ||
(A) the methodology by which the executive | ||
commissioner set the payment rates; | ||
(B) the data sources used; | ||
(C) the components of the process that are | ||
assumptions and how the assumptions are developed; | ||
(D) multipliers and factors used throughout the | ||
reports, including the source and purpose of the multipliers and | ||
factors; and | ||
(E) the methodology by which the executive | ||
commissioner determined that the rates are actuarially sound for | ||
the populations covered and the services provided. | ||
(b) Notwithstanding Subsection (a), the commission is not | ||
required to publish particular information in an actuarial report | ||
if the commission determines the information is proprietary. | ||
SECTION 2. Subchapter B, Chapter 62, Health and Safety | ||
Code, is amended by adding Section 62.061 to read as follows: | ||
Sec. 62.061. TRANSPARENCY OF PREMIUM PAYMENT RATE-SETTING | ||
PROCESS. (a) The commission shall ensure the transparency of the | ||
premium payment rate-setting process for the child health plan | ||
program by publishing actuarial reports: | ||
(1) in a format that allows for tracing data and | ||
formulas across attachments, exhibits, and examples; and | ||
(2) that clearly identify and describe: | ||
(A) the methodology by which the executive | ||
commissioner set the payment rates; | ||
(B) the data sources used; | ||
(C) the components of the process that are | ||
assumptions and how the assumptions are developed; | ||
(D) multipliers and factors used throughout the | ||
reports, including the source and purpose of the multipliers and | ||
factors; and | ||
(E) the methodology by which the executive | ||
commissioner determined that the rates are actuarially sound for | ||
the populations covered and the services provided. | ||
(b) Notwithstanding Subsection (a), the commission is not | ||
required to publish particular information in an actuarial report | ||
if the commission determines the information is proprietary. | ||
SECTION 3. If before implementing any provision of this Act | ||
a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 4. This Act takes effect September 1, 2019. |