Bill Text: TX SB191 | 2021-2022 | 87th Legislature | Introduced
Bill Title: Relating to the use of social determinants of health in the Medicaid managed care program.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2021-03-03 - Referred to Health & Human Services [SB191 Detail]
Download: Texas-2021-SB191-Introduced.html
87R2217 KFF-D | ||
By: Johnson | S.B. No. 191 |
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relating to the use of social determinants of health in the Medicaid | ||
managed care program. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 533.001, Government Code, is amended by | ||
adding Subdivision (6-a) to read as follows: | ||
(6-a) "Social determinants of health" means the | ||
environmental conditions in which a person is born, lives, learns, | ||
works, plays, worships, and ages that affect a range of health, | ||
functional, and quality of life outcomes and risks. | ||
SECTION 2. Section 533.003(a), Government Code, is amended | ||
to read as follows: | ||
(a) In awarding contracts to managed care organizations, | ||
the commission shall: | ||
(1) give preference to organizations that have | ||
significant participation in the organization's provider network | ||
from each health care provider in the region who has traditionally | ||
provided care to Medicaid and charity care patients; | ||
(2) give extra consideration to organizations that | ||
agree to assure continuity of care for at least three months beyond | ||
the period of Medicaid eligibility for recipients; | ||
(3) consider the need to use different managed care | ||
plans to meet the needs of different populations; | ||
(4) consider the ability of organizations to process | ||
Medicaid claims electronically; and | ||
(5) give extra consideration to organizations that use | ||
enriched data sets incorporating social determinants of health to | ||
manage socially complex populations in a manner that achieves: | ||
(A) cost savings through implementation of | ||
appropriate interventions for those populations; and | ||
(B) favorable health outcomes for those | ||
populations by reducing preventable emergency room visits, | ||
hospitalizations, and institutionalizations [ |
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SECTION 3. Subchapter A, Chapter 533, Government Code, is | ||
amended by adding Section 533.022 to read as follows: | ||
Sec. 533.022. ANNUAL REPORT ON USE OF SOCIAL DETERMINANTS | ||
OF HEALTH. Each Medicaid managed care organization that uses | ||
enriched data sets described by Section 533.003(a)(5) shall submit | ||
to the commission an annual report that assesses any cost savings | ||
and favorable health outcomes achieved by using those data sets. | ||
SECTION 4. Section 533.003(a), Government Code, as amended | ||
by this Act, applies to a contract entered into or renewed on or | ||
after the effective date of this Act. A contract entered into or | ||
renewed before that date is governed by the law in effect on the | ||
date the contract was entered into or renewed, and that law is | ||
continued in effect for that purpose. | ||
SECTION 5. 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 6. This Act takes effect immediately if it receives | ||
a vote of two-thirds of all the members elected to each house, as | ||
provided by Section 39, Article III, Texas Constitution. If this | ||
Act does not receive the vote necessary for immediate effect, this | ||
Act takes effect September 1, 2021. |