Bills that Passed Recap
While a number of bills relating to the implementation of healthcare exchange failed to pass this session, there were a few successes. Healthcare legislation passed during the 82nd legislative session relates to establishing a health care compact, cost containment, access to services through managed care, and the creation of economic and structural incentives to improve the quality of Medicaid services. Two successes in health care legislation this session were SB 7 and HB 2610.
SB 7:
This major healthcare bill, authored by Senator Jane Nelson, is other wise known as the “Healthcare Omnibus Bill.” The bill was introduced during regular session and failed but with revisions it passed during the special session. The bill was drafted with the aims of improving efficiency in the delivery of healthcare. The legislation includes strategies for improvements in the quality of healthcare provided specifically through the Children’s Health Insurance Program (CHIP) and Medicaid.
SB 7 encompasses elements from three other regular session bills, specifically portions of the following bills:
- SB 23, relating to efficiencies, cost savings and fraud prevention in Medicaid and CHIP
- SB7, achieving savings in Medicaid and Chip through re-focusing healthcare funds on better patient outcomes. Additionally these provisions expand managed care into the Rio Grande Valley and adds a cost-saving prescription drug benefit into Medicaid Managed Care.
- SB8, allowing healthcare providers to form collaboratives to better coordinate care.
Major provisions of the legislation include:
The Health Care Compact– Will allow Texas to join an interstate compact to take on any and all federal health care programs including Medicare, Medicaid, CHIP, FQHCs and mental health block grants. The Health Care Compact is an agreement between participating states that restores authority and responsibility for health care regulation to member states. The compact allows Texas to create its own health care policies by joining an interstate compact that supersedes prior federal law. (Texas is the fourth state to sign the compact into law following Georgia, Oklahoma, and Missouri.)
The 1115 Medicaid Flexibility Waiver – Requires HHSC to seek a Section 1115 Medicaid waiver to provide flexibility in determining eligibility categories, income levels and benefits; consolidates funding streams; encourages personal responsibility through a sliding scale, with fees paid at the point of service, and use of private insurance; and allows the redesign of long-termcare services and supports to increase access to patient-centered care in the most cost effective manner.
Individual and Provider Changes – Requires co-pay for Medicaid and CHIP patients who make unnecessary emergency room visits; lets healthcare providers formcollaborative to create a statewide system to quickly identify risk factors in individual patients; reward providers who reduce waste; restructures payment system for Medicaid and CHIP; and seeks repayment for health care of sponsored adult immigrants.
Other provisions include the expansion of Medicaid managed care to the Rio Grande Valley; utilization reviews to prevent fraud and waste; and authorization to reduce payments for treatment associated with preventable medical errors.
HB 2610, or the Navigators Bill, was major success of the session. Through the new Navigator program established in HB 2610, local faith and community-based organizations will be able to ensure that Texas' enrollment system works optimally. The bill, authored by Rep. Guillen, directs the Texas Health and Human Services Commission (HHSC) to establish a “community-based navigator program” to train and certify faith and community-based organizations to assist individuals applying online for public benefits like SNAP and Medicaid through HHSC’s new public web portal, which will be available statewide in early 2012.
The bill will help faith and community-based organizations (FCBOs) to serve their communities more effectively, and at the same time provide needed protections and clarity for local groups that want to provide application assistance. This legislation aims to improve efficiency and maximize the effectiveness of TIERS. HHSC has rolled out its enhanced web-based application, which moves Texas from its paper-based system to an online application that is accessible from anywhere at any time, increasing productivity for state employees. To learn more about the bil please read CTN member Texas Impact's article covering the bill details.
HB 1951, authored by Representative Larry Taylor, otherwise known as the Texas Department of Insurance (TDI) Sunset Bill continues the duties and operations of the state agency. The bill seeks to strengthen various aspects of the agency, including health insurance.
One significant amendment strengthening the bill is geared at children’s health coverage. The amendment, by Senator Rodney Ellis, allows TDI to adopt rules to increase the availability of coverage to children, younger than 19 years of age, by establishing open enrollment periods. Additionally this provision allows TDI to define and establish rules related to qualifying events for children, so that under certain circumstances, children can enroll immediately without having to wait for the next open enrollment period.
This legislation aims to address shortages of physicians and lessen costs of healthcare through video consulting, diagnostics and remote monitoring of healthcare. Specifically the legislation directs HHSC to establish and allow reimbursement under Medicaid for statewide in-home telemedicine medical services, telehealth services and home telemonitoring services provided to certain Medicaid recipients.
