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.
Sponsorship: Partisan Bill (Democrat 1)
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. | ||
