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
  relating to the use of social determinants of health in the Medicaid
  managed care program.
         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 [in the initial
  implementation of managed care in the South Texas service region,
  give extra consideration to an organization that either:
                     [(A)  is locally owned, managed, and operated, if
  one exists; or
                     [(B)  is in compliance with the requirements of
  Section 533.004].
         SECTION 3.  Subchapter A, Chapter 533, Government Code, is
  amended by adding Section 533.022 to read as follows:
  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.