Bill Text: TX SB171 | 2021-2022 | 87th Legislature | Engrossed

Texas Senate Bill 171 (Prior Session Legislation)

Bill Title: Relating to a report regarding Medicaid reimbursement rates, supplemental payment amounts, and access to care.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Engrossed - Dead) 2021-05-18 - Left pending in committee [SB171 Detail]

Download: Texas-2021-SB171-Engrossed.html



	By: Blanco, et al.	S.B. No. 171


	A BILL TO BE ENTITLED
	AN ACT
	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 the Texas Healthcare
	Transformation and Quality Improvement Program waiver issued under
	Section 1115 of the Social Security Act (42 U.S.C. Section 1315),
	another program operating under a waiver to the state Medicaid plan
	that provides a payment in excess of the Medicaid reimbursement
	rate, or the Medicaid disproportionate share hospital payment
	program.
	(b) The commission shall prepare a written report regarding
	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;
	(B) the quality incentive payment program
	(QIPP); and
	(C) the minimum reimbursement rate for nursing
	facilities described by Section 533.00251, Government Code; 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, 2022, 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, 2021.