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22 Document(s) [ Subject: Health care costs ]

Committee:	House Health Care Reform, Select
Title:	Interim Report
Subjects:	Children's Health Insurance Program | Disease prevention | Health care | Health care costs | Health care disparities | Health insurance | Medicaid | Medical screening | Prescription drug costs |
Library Call Number:
Session:	87th R.S. (2021)
Online version:	View report [102 pages  File size: 2,402 kb]
Charges:	This report should address the charges below.
1.	Study the implications of excessive health care costs on the efficacy of Texas Medicaid and the private health insurance market and the resulting impact on individual Texans, businesses, and state government. Specifically, the committee shall: Examine the interaction of specific factors of health care affordability such as transparency, competition, and patient incentives. Make recommendations to expand access to health care price information to allow consumers to make informed decisions regarding their care; Examine the impact of government benefit, administrative, and contractual mandates imposed upon private insurance companies and their impact on employer and consumer premiums and out-of-pocket costs, including the effects of specific benefit and any-willing-provider requirements. Make recommendations for state and agency level mandates and regulations that could be relaxed or repealed to increase the availability and affordability of private health coverage options in this state; and Review access to and affordability of prescription drugs.
2.	Monitor the implementation of, and compliance with, current price transparency requirements and study ways that the state can support patients and increase competition. Make legislative and administrative recommendations, as appropriate.
3.	Evaluate innovative, fiscally positive options to ensure that Texans have access to affordable, quality, and comprehensive health care, with an emphasis on reaching low income and at-risk populations. The evaluation should include a study of strategies other states and organizations have implemented or proposed to address health care access and affordability. Make recommendations to increase primary health care access points in Texas.
4.	Study ways to improve outreach to families with children who are eligible for, but not enrolled in, Medicaid or CHIP, including children in rural areas.
5.	Examine the potential impact of delayed care on the state's health care delivery system, health care costs, and patient health outcomes, as well as best practices for getting patients with foregone or delayed health interventions back into the health care system. The study should consider patient delays in obtaining preventive and primary health services, such as well-child care, prenatal care, screenings for cancer and chronic disease, behavioral health, and immunizations, in addition to delays in seeking urgent care or care for chronic illness.
Supporting documents
Committee:	House Health Care Reform, Select
Title:	Committee meeting handouts and testimony, August 4, 2022
Library Call Number:
Session:	87th R.S. (2021)
Online version:	View document [584 pages  File size: 53,345 kb]
Committee:	Senate Health and Human Services
Title:	Interim Report
Subjects:	Child abuse | Child Protective Services | Emergency management | Employees Retirement System of Texas | Family and Protective Services, Texas Department of | Foster care | Health and Human Services Commission, Texas | Health care costs | Healthy Texas Women | Hurricane Harvey | Insurance, Texas Department of | Juvenile justice system | Managed care | Medicaid | Natural disasters | Opioids | Prescription drugs | Public health | State Health Services, Texas Department of | Substance abuse | Teacher Retirement System of Texas |
Library Call Number:	L1836.85 H349
Session:	85th R.S. (2017)
Online version:	View report [98 pages]
Charges:	This report should address the charges below.
1.	Review the state's response to Hurricane Harvey with a focus on public health efforts at the local and state level. The review should include an analysis of the state and local response related to vector control, immunization needs, utilization of health-related volunteers, adequacy of an emergency medical network, evacuation of vulnerable populations from state operated or regulated facilities, and coordination between all levels of government. Recommend any legislative changes necessary to improve public health response and coordination during and after a disaster.
2.	Evaluate the impact of Hurricane Harvey on the capacity of out-of-home placements and care for youth involved with the juvenile justice and child welfare systems. Determine how the state can ensure support is available to provide appropriate care as close to home as possible as facilities and offices are rebuilt.
3.	Child Welfare: Review the efficacy and quality of services offered to ensure family preservation while in the Family Based Social Services (FESS) stage of service at the Department of Family and Protective Services. Make recommendations to better track quality of services and link payments to providers of these services to outcomes for families and children. Analyze the Department of Family and Protective Services' progress in meeting statutory requirements related to timely visits to children involved in a reported case of abuse or neglect. Make recommendations to further improve the timeliness of these visits. Review services and supports provided to children in Permanent Managing Conservatorship of the state, and the level of preparedness given to youth aging out of state care. Examine the impact of recent legislation related to these populations, and make recommendations to ensure youth in care are ready for adulthood and to reduce the likelihood of intergenerational perpetuation of child maltreatment. Assess the effectiveness of public and private agency efforts to recruit and retain foster parents. Identify barriers to entry and obstacles that prevent interested families from continuing to provide foster care. Recommend solutions to increase foster recruitment and address non-renewals, especially in first-time foster parents.
4.	Substance Abuse/Opioids: Review substance use prevention, intervention, and recovery programs operated or funded by the state and make recommendations to enhance services, outreach, and agency coordination. Examine the adequacy of substance use, services for pregnant and postpartum women enrolled in Medicaid or the Healthy Texas Women Program and recommend ways to improve substance use related health outcomes for these women and their newborns. Examine the impact of recent legislative efforts to curb overprescribing and doctor shopping via the prescription monitoring program and recommend ways to expand on current efforts.
5.	Medicaid Managed Care Quality and Compliance: Review the Health and Human Services Commission's efforts to improve quality and efficiency in the Medicaid program, including pay-for-quality initiatives in Medicaid managed care. Compare alternative payment models and value-based payment arrangements with providers in Medicaid managed care, the Employees Retirement System, and the Teachers Retirement System, and identify areas for cross-collaboration and coordination among these entities. Evaluate the commission's efforts to ensure Medicaid managed care organizations' compliance with contractual obligations and the use of incentives and sanctions to enforce compliance. Assess the commission's progress in implementing competitive bidding practices for Medicaid managed care contracts and other initiatives to ensure the best value for taxpayer dollars used in Medicaid managed care contracts.
6.	Health Care Cost Transparency: Study efforts by the Department of State Health Services and the Texas Department of Insurance to increase health care cost transparency, including a review of the Texas Health Care Information Collection (THCIC) system, and the Consumer Guide to Healthcare. Recommend ways to make provider and facility fees more accessible to consumers to improve health care cost transparency, increase quality of care, and create a more informed health care consumer base.
7.	Monitoring Charge: Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services, 85th Legislature and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to: • Initiatives to increase capacity and reduce waitlists in the mental health system, including the construction of state hospitals and new community grant programs; • Initiatives to better understand the causes of maternal mortality and morbidity, including the impact of legislation passed during the first special session of the 85th Legislature. Recommend ways to improve health outcomes for pregnant women and methods to better collect data related to maternal mortality and morbidity; • Initiatives intended to improve child safety, Child Protective Services workforce retention, and development of additional capacity in the foster care system. Make additional recommendations to ensure children with high levels of medical or mental health needs receive timely access to services in the least restrictive setting; • Efforts to transfer case management of foster children and families to Single Source Continuum Contractors (SSCCs). Monitor the progress of this transition and make recommendations to ensure the process provides continuity of services for children and families and ongoing community engagement; • Initiatives to strengthen oversight of long-term care facilities to ensure safety and improve quality for residents and clients of these entities; and • Abortion complications and other reporting legislation that was passed by the 85th Legislature.
Committee:	Senate State Affairs
Title:	Interim Report
Subjects:	Biometric identification | Cellular telephones | DNA databases | e-government | Electronic surveillance | Employees Retirement System of Texas | Health care costs | Health care navigators | Health insurance exchanges | Health insurance pools | Legislature, Texas | Medical billing | Patents | Patient Protection and Affordable Care Act | Personally identifiable information | Privacy | Rules of the Texas Senate | Search warrants | Searches and seizures | Small businesses | Teacher Retirement System of Texas | Texas Health Insurance Risk Pool | Texas Legislature Online | Texas Mutual Insurance | Websites | Workers' compensation |
Library Call Number:	L1836.83 St29a
Session:	83rd R.S. (2013)
Online version:	View report [128 pages]
Charges:	This report should address the charges below.
1.	Examine the negative economic impact on Texas business from legal issues involving threatened and actual patent litigation by "patent assertion entities" (PAEs). Consider the effects of PAE actions on innovation and economic development in Texas, paying particular attention to threats and lawsuits involving software and technology patent claims. Make recommendations on how the State of Texas can address problems related to frivolous legal actions and unsubstantiated patent claims asserted against legitimate business enterprises in light of the relevant federal jurisdiction, laws, regulations, and court rules in patent cases.
2.	Examine possible measures to protect the personal privacy of Texas residents from governmental and commercial surveillance, including: (1) any necessary limits on warrantless search and seizure of data from electronic devices and wireless providers, including digital content and geolocational data; (2) any necessary protections against non-consented video and audio recordings collected by private handheld and wearable mobile devices and other private surveillance; and (3) any necessary limits on warrantless monitoring of the physical location of individuals through the use of biometrics, RFID chips, facial recognition, or other technologies. Examine related measures proposed or passed in other states.
3.	Review the types and scope of personal data collected by governmental and commercial entities and consider methods to minimize the government’s collection of data on its citizens. The study should include: (1) whether sufficient protections exist for DNA samples and information, including whether there should be a prohibition on the creation of DNA databases, except for felons and sex offenders; (2) methods to protect the privacy of gun owners from aggregated purchasing pattern tracking; (3) mechanisms to ensure that private health care information is properly protected; and (4) ways to ensure that previously anonymous data is not improperly re-identified and marketed. Examine related measures proposed or passed in other states.
4.	Examine possible reforms designed to increase citizens' ability to know what data is being collected about them by governmental andcommercial entities and with whom that data is being shared, including an analysis of consumer informed consent. Examine related measures proposed or passed in other states.
5.	Study the online legislative resources available to the public from Texas Senate Committee websites and compare esources to those provided by other state legislative committees in Texas and other states. Determine how Texas Senate websites can be improved to provide a more interactive and transparent government.
6.	Study the emerging negative impacts of the Federal Affordable Care Act, including the use of navigators, and make recommendations to mitigate any unintended consequences including rising health insurance premiums, lack of access to healthcare, mishandling of Texans' private information by insufficiently-trained navigators, and the Act’s overall effect on Texas employers and insurance consumers. Evaluate free-market alternatives to the Act, including state-led proposals to repeal, reduce or replace the Act. Closely monitor and make recommendations on the continuation of the Texas Health Insurance Pool.
7.	Study and make recommendations on increasing medical price transparency in Texas, including studying the impact of SB 1731, 80th Legislative Session. Analyze relevant reforms considered or implemented in other states, and make recommendations regarding potential changes designed to create a more open marketplace for enhanced consumer decision making in Texas.
8.	Monitor the actuarial and financial conditions of the pension and health care programs administered by the Teacher Retirement System (TRS) and the Employees Retirement System (ERS).
9.	Monitor the implementation of legislation addressed by the Senate Committee on State Affairs, 83rd Legislature, Regular Session, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
10.	Study and make recommendations relative to the structure of Texas Mutual Insurance Company and the residual market for workers’ compensation insurance in Texas.
Committee:	Senate Health and Human Services
Title:	Interim Report
Subjects:	Cancer Prevention and Research Institute of Texas | Caseworkers | Child Protective Services | Children's Health Insurance Program | Dental care | Foster care | Health care | Health care costs | Health insurance | Immunizations | Long-term care | Managed care | Medicaid | Medicaid eligibility | Medical research | Mental health services | Nursing homes | Patient Protection and Affordable Care Act | Public health | State Health Services, Texas Department of | State supported living centers |
Library Call Number:	L1836.82 H349
Session:	82nd R.S. (2011)
Online version:	View report [186 pages]
Charges:	This report should address the charges below.
1.	Monitor the potential impact of the Patient Protection and Affordable Care Act (PPACA) on insurance regulations, Medicaid and CHIP, health care outcomes and overall health of all Texans, and the state budget in Texas. Additionally, monitor the current constitutional challenges to PPACA and other court cases associated with PPACA, and ensure that the state does not expend any resources until judicial direction is clear. (Joint charge with Senate State Affairs Committee)
2.	Monitor the potential impact of the Patient Protection and Affordable Care Act (PPACA) on insurance regulations, Medicaid and Children's Health Insurance Program (CHIP), health care outcomes, health care workforce, overall health of all Texans, and the state budget in Texas. Additionally, monitor the current constitutional challenges to PPACA, and other court cases associated with PPACA, and ensure that the state does not expend any resources until judicial direction is clear. (Joint charge with Senate State Affairs Committee)
3.	Evaluate the implementation of cost-containment strategies across the Health and Human Services Enterprise to determine if and how each strategy can be expanded upon to achieve additional savings next biennium. The evaluation should include but is not limited to: the expansion of managed care, co-­pays in Medicaid, electronic visit verification, and independent assessments for long-­? term care services. The evaluation should also consider new cost-containment strategies that will increase efficiencies and reduce costs. This evaluation should include but not be limited to: Medicaid, Early Childhood Intervention Services, and immunizations.
4.	Review the state's current investment in health care innovation, including translational research and the Cancer Prevention Research Institute, which focuses on rapid transfer of new technology experimentation directly into the clinical environment. Make recommendations to improve the health of Texans and encourage continued medical research in the most cost-effective manner possible.
5.	Review existing policies for prior authorization and medical necessity review across the Medicaid Program, including nursing homes and orthodontic services. Make recommendations on how these policies could be improved to save money by reducing unnecessary utilization and fraud.
6.	Review the Medicaid Home and Community Based Services Waivers to identify strategies to lower costs, improve quality, and increase access to services. Areas of the review should include, but are not limited to: Functional eligibility determinations to ensure services are only being delivered to individuals that qualify; Financial eligibility determinations to ensure parental income and resources are considered when the client is a minor; Coordination of acute and long-term care services; Development and use of lower-cost community care waiver options; Coordination with the Department of Family and Protective Services (DFPS) for waiver services for children in conservatorships; Reinvesting savings into accessibility of community care for individuals waiting for services.
7.	Evaluate the management structure and supervision of CPS caseworkers with an emphasis on rural areas. Identify any legislative changes that could assist DFPS in maximizing efficiency, improving quality casework and supervision, and increasing caseworker retention. Identify any legislative changes that could improve the quality of care children receive while in Child Protective Services custody, including improving permanency outcomes.
8.	Examine the delivery and financing of public health services in our state, including how federal funds are distributed by the state to local health departments and whether the work done by Regional Health Departments operated by the Department of State Health Services overlap unnecessarily with local health departments.
9.	Review the state's public mental health system and make recommendations to improve access, service utilization, patient outcomes and system efficiencies. Study current service delivery models for outpatient and inpatient care, funding levels, financing methodologies, services provided, and available community-based alternatives to hospitalization. The review should look to other states for best practices or models that may be successful in Texas. The study shall also review and recommend "best value" practices that the state's public mental health system may implement to maximize the use of federal, state, and local funds.
10.	Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to: Health Care Quality and Efficiency - Monitor implementation of initiatives aimed at improving health care quality and efficiency in Texas, including: the transition of Medicaid and the CHIP to quality-based payments, establishment of the Texas Institute of Health Care Quality and Efficiency, implementation of the Health Care Collaborative certificate, patient-centered medical home for high-cost populations, development and use of potentially preventable event outcome measures, and reduction of health care-associated infections. Include recommendations on how to improve and build upon these initiatives, including improving birth outcomes and reducing infant and maternal mortality; Federal Flexibility - Monitor implementation of initiatives to increase state flexibility, including the Health Care Compact and the Medicaid Demonstration Waiver; Foster Care Redesign - Monitor implementation of the initiative to redesign the foster care system; Implementation of DOJ Settlement agreement to address State Supported Living Center concerns.
Committee:	House Public Health
Title:	Interim Report
Subjects:	Dental care | Dental Examiners, Texas State Board of | Farms and farming | Food safety | Food stamps | Health care costs | Hunger | Medicaid | Medical education | Medical records | Nurse practitioners | Patient Protection and Affordable Care Act | Physician assistants | Physician shortages | Property tax exemptions | Public health | School nutrition | Small farms | State hospitals |
Library Call Number:	L1836.82 H349h
Session:	82nd R.S. (2011)
Online version:	View report [66 pages]
Charges:	This report should address the charges below.
1.	Examine the adequacy of the primary care workforce in Texas and assess the impact of an aging population, the passage of the Patient Protection and Affordable Care Act, and state and federal funding reductions to graduate medical education and physician loan repayment programs. Study the potential impact of medical school innovations, new practice models, alternative reimbursement strategies, expanded roles for physician extenders, and greater utilization of telemedicine. Make recommendations to increase patient access to primary care and address geographic disparities.
2.	Study the various health registries maintained by the state, including the similarities and differences in reporting, consent, security, and portability of data. Assess registry compliance with standards for the protection and transmission of registry data and identify any additional steps necessary to ensure security, efficiency, and utilization.
3.	Monitor implementation of the federal Patient Protection and Affordable Care Act, including any changes that may result from ongoing litigation or legislative modification or repeal. (Joint with the House Committee on Insurance)
4.	Identify policies to alleviate food insecurity, increase access to healthy foods, and incent good nutrition within existing food assistance programs. Consider initiatives in Texas and other states to eliminate food deserts and grocery gaps, encourage urban agriculture and farmers' markets, and increase participation in the Summer Food Program. Evaluate the desirability and feasibility of incorporating nutritional standards in the Supplemental Nutrition Assistance Program (SNAP). Monitor congressional activity on the 2012 Farm Bill and consider its impact on Texas. (Joint with the House Committee on Human Services)
5.	Monitor the agencies and programs under the committee's jurisdiction and the implementation of relevant legislation passed by the 82nd Legislature.
Supporting documents
Committee:	House Public Health
Title:	Committee meeting handouts and testimony, May 15, 2012 (1115 Health Transformation Waiver; Charge 1, Primary care workforce)
Library Call Number:
Session:	82nd R.S. (2011)
Online version:	View document [196 pages  File size: 9,926 kb]
Committee:	House Public Health
Title:	Interim Report
Library Catalog Title:	House Committee on Public Health, Texas House of Representatives interim report, 2010 : a report to the House of Representatives, 82nd Texas Legislature
Subjects:	Diet and nutrition | Emergency management | Employees Retirement System of Texas | Food safety | H1N1 virus | Health care | Health care costs | Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome | Influenza | Medicaid | Obesity | Parents | Teacher Retirement System of Texas |
Library Call Number:	L1836.81 H349h
Session:	81st R.S. (2009)
Online version:	View report [84 pages  File size: 854 kb]
Charges:	This report should address the charges below.
1.	Monitor implementation of legislation intended to curb rising obesity rates in Texas. Study and make recommendations regarding better coordination of prevention efforts and evidence-based strategies to reduce the impact of obesity on health care costs. Include recommendations related to the use of federal stimulus funds targeted toward obesity prevention.
2.	Study the state's ability to respond to the H1N1 virus. Examine issues related to vaccine and antiviral distribution and capacity, disease surveillance, communication with providers and the public, intergovernmental cooperation, and medical surge capability.
3.	Determine how the state can best coordinate efforts to streamline health care delivery with health information technology (HIT). Identify areas in state law that affect the adoption and use of HIT. Recommend statutory changes as necessary.
4.	Identify factors influencing health care cost trends in Texas, including practices or policies that may contribute to regional variations. Investigate medical imaging utilization and its impact on the cost and quality of health care. Recommend policy changes to promote best practices, reduce costs, and improve quality within the state Medicaid program, Employees Retirement System, and Teacher Retirement System. Joint Interim Charge with House Committee on Appropriations
5.	Examine the need for and barriers to implementing routine HIV screenings as recommended in 2006 by the Centers for Disease Control and Prevention. Assess the impact of implementation on HIV transmission, health outcomes, clinical progression, and mortality.
6.	Pursuant to HB 1672, 81st R.S., Section 4, study the policies and procedures related to the disclosure required by Chapter 33, Health and Safety Code, to the parent, managing conservator, or guardian of a newborn child.
7.	Identify any gaps in Texas laws that may prevent coordinated efforts, both statewide and on the border, to ensure a safe food supply. Joint Interim Charge with House Committee on Border and Intergovernmental Affairs
8.	Monitor the agencies and programs under the committee's jurisdiction.
Committee:	Senate State Affairs
Title:	Interim Report
Library Catalog Title:	Interim report to the 82nd Legislature
Subjects:	Employees Retirement System of Texas | Financial investments | Fraud | Health care | Health care costs | Health insurance | Hospitals | Insurance agents | Insurance rates | Medically uninsured | Military personnel | Open government | Open Meetings Act, Texas | Public Information Act, Texas | Senior citizens | Teacher Retirement System of Texas | Voter registration | Voters | Voting by mail | Voting systems | Workers' compensation |
Library Call Number:	L1836.81 ST29a
Session:	81st R.S. (2009)
Online version:	View report [248 pages  File size: 24,817 kb]
Charges:	This report should address the charges below.
1.	Upon passage of federal legislation relating to reform of the health care industry and health insurance industry, study the implications of such legislation on Texas, the health care industry, and public and private insurance. Study and monitor the implementation of the insurance regulatory changes, changes to high risk pool, and any other insurance mandates. Study the health care policy changes and the impact to the Medicaid and CHIP programs and the state budget. Assess the impact to all state uninsured and uncompensated care programs and county programs for the uninsured, including county property tax programs to pay for the uninsured. Make recommendations for the efficient implementation of programs. (Joint charge with Senate Health and Human Services Committee)
2.	Monitor the actuarial and financial conditions of the pension and health care programs administered by the Teacher Retirement System and the Employees Retirement System. Assess the effectiveness of pilot programs designed to encourage the use of clinical integration, payments for good outcomes, use of best practices, focus on wellness and prevention, and bundling of costs for episodes of care, and other health care savings initiatives. Make recommendations for expanding the pilot programs for use across all private and state sponsored health care, including the Medicaid program, as a means to improve Texans' health and provide more effective care that allows for assistance for the uninsured. (SB 7, SB 8 and SB 10, 81st Legislature)
3.	Study the implementation of the Healthy Texas program enacted by the 81st Legislature and the ongoing implementation of SB 1731, 80th Legislature, to determine if this program is effectively lowering health insurance costs and increasing access to health insurance for small business. Study and make recommendations about using this program to increase access to health insurance for sole proprietors. Review other states efforts to lower health care costs to small business owners and sole proprietors and incentivize small business owners and sole proprietors to purchase insurance.
4.	Examine best practices for increasing the affordability and availability of health insurance in the individual and small group market, including medical underwriting practices, rescission of coverage, cancellation of coverage, rate regulation, and reporting of medical loss ratios.
5.	Study how increased out-of-pocket costs for medications and treatment impact consumers' compliance with health care recommendations and how that response impacts overall health care costs. Review available research into value design programs.
6.	Study ways to improve the efficiency and accuracy of voter registration rolls, including the feasibility and security of online registration and automatic registration and the accuracy of verification and purging of voters. Recommend ways to ensure that deceased or otherwise ineligible voters are not included on rolls while also ensuring that all eligible applicants are efficiently registered.
7.	Study the transparency of organizational structures, policies and coverage associated with health insurance underwriters/agents and the relationship between underwriters/agents and policyholders.
8.	Study the sale of annuities in Texas, particularly to seniors. Evaluate the requirements relating to rescission of an annuity contract, payment of surrender fees, return of money, contract forms, including a standard contract form, buyer's guide, agent's commission and disclosure of an agent's commission. Make recommendations for legislation, if needed, and consider whether the insurance commissioner by rule may limit an agent's commission.
9.	Study the effect Texas hospital billing and collection practices have on the uninsured's and under-insured's access to hospital health care services, on the uninsured's and under­insured's economic circumstances, and on medical debt recorded as bad debt on hospital books and records. Assess whether hospital billing disparities involving pricing discounts between the uninsured and insured exist and make recommendations for any changes necessary.
10.	Study the adequacy of workers' compensation benefits in the following categories: lifetime income benefits, wage benefits for the high wage earner, and workers whose wage benefits stop before Social Security benefits begin. In order to determine the impact of increased benefits in one or more of these categories, work with the Texas Department of Insurance to develop a publicly accessible model to predict the costs related to those enhanced benefits, the effect of those costs on workers' compensation premiums, and whether enrollment in the workers' compensation system will be adversely impacted by increasing the benefits in one or more of the stated categories.
11.	Study whether subrogation claims by writers of workers' compensation policies should be limited or prohibited. Study the effect on workers' compensation premiums, if any, if subrogation claims by writers of workers' compensation policies are limited or prohibited. Consider the feasibility of developing a publicly accessible model to predict the impact on workers' compensation premiums, if any, if subrogation claims by writers of workers' compensation policies are limited or prohibited, while protecting confidentiality as required by law and study whether the impact on workers' compensation premiums, if any, would adversely impact enrollment in the workers' compensation system.
12.	Study and make recommendations regarding access to voting by members of the military serving in the United States and abroad, including the feasibility of electronic delivery of ballots.
13.	Study the Public Information Act and the Open Meetings Act to ensure that government continues to operate in a way that is open and transparent. The study should consider how advances in technology and the emergence of various forms of social media (e.g. Facebook, MySpace, Twitter) have affected communications by and within governmental bodies.
14.	Monitor the implementation of legislation addressed by the Senate Committee on State Affairs, 81 st Legislature, Regular and Called Sessions, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
Committee:	Senate Finance
Title:	Interim Report - General Government
Library Catalog Title:	Interim report
Subjects:	Existing Debt Allotment | Fiscal management | Health care costs | Hospital districts | Hospitals | Instructional Facilities Allotment Program | Privatization | School buildings | School districts | School finance | State land | Texas Lottery |
Library Call Number:	L1836.80 F49g
Session:	80th R.S. (2007)
Online version:	View report [51 pages  File size: 8,320 kb]
Charges:	This report should address the charges below.
1.	Study the effectiveness of cash management strategies of the state. Review the quarterly amount of cash on hand and its use and potential to generate excess returns. Include an assessment of cash flow problems that exist in school districts and request that the Comptroller of Public Accounts report on the additional short-term borrowing needed and the potential impact on bond ratings if legislation is not passed which allows for the "smoothing" of state payments to school districts.
2.	Explore the policy implications of allowing school districts, or other public agencies, to participate in a permissive pooled collateral program which provides for the centralization of collateral in a pool which will be tracked and verified to meet state requirements.
3.	Compile a list of significant state assets and infrastructure, including but not limited to the state lottery and state real property, and determine if each asset is being used to the highest and best use possible in the interest of taxpayers of Texas. Where appropriate, provide analysis of alternative uses of underperforming assets, potential cost savings or revenue gains and the legislative actions that would be needed to make the changes that are in the best interest of taxpayers.
4.	Study the funding of county public hospitals and the role neighboring counties without a county hospital should play.
5.	Review and evaluate appropriate state regulation of a private operator of the state lottery should the state receive bids for a lease of the lottery that merit strong consideration. Provide recommendations for ensuring the security and integrity of the lottery and for adequate consumer protections. (Joint charge with Senate State Affairs Committee)
6.	Review and make recommendations that address the state's facility infrastructure needs for public schools, ensuring that funding remains stable, reliable and equitable. Examine the need for funding adjustments for factors that affect the need for facilities, such as fast growth, age and condition of facilities, adequacy of space, construction and land costs, and concentration of students requiring smaller class sizes. Assess the impact on property taxpayers of “rolling forward” the Existing Debt Allotment (EDA) each session and the change in biennial appropriations for the Instructional Facilities Allotment (IFA). (Joint Charge with Senate Education Committee)
Committee:	Senate State Affairs
Title:	Interim Report
Subjects:	Eight-liners | Election fraud | Employees Retirement System of Texas | Entergy Corporation | Gambling | Health care costs | Health insurance | Health maintenance organizations | Insurance industry | Investment of public funds | Legislative intent | Medical research | Medically uninsured | Mental health services | Mentally ill inmates | Mentally ill persons | Privatization | Public retirement systems | Statutory revision | Strategic Lawsuits Against Public Participation | Texas Health Insurance Risk Pool | Texas Lottery | Tort reform | Voter identification | Voting systems | Workers' compensation |
Library Call Number:	L1836.80 St29a
Session:	80th R.S. (2007)
Online version:	View report [308 pages  File size: 43,740 kb]
Charges:	This report should address the charges below.
1.	Study the factors that impact the transparency and efficiency of the health insurance market. Make recommendation to result in the use of best practices, lower health care costs, and better health outcomes, including the following: Study factors contributing to the increasing cost of health care; Study insurer and health maintenance organization (HMO) use of tiers, ratings, or classifications to differentiate among credentialed physicians already admitted to the insurer or HMO panel of preferred providers or network; Examine methods to remediate incorrect tiering, ratings, or classifications; Examine how physicians are notified of the standards against which they will be compared and whether they are notified of the standards prior to the evaluation period; Improve transparency with respect to the marketing of prescription drugs; and Study the use of certain nonprofit health corporations - approved under Chapter 162, Occupations Code, in Texas. Examine whether such entities operate on a statewide scale or on a limited scale, whether such entities adhere to the formalities required of corporations, whether the operation of such entities are influenced by owners or members who are not licensed to practice medicine, and whether such entities have ever been decertified or investigated for failure to maintain compliance with Texas law or regulations.
2.	Study and make recommendations for reducing the number of uninsured Texans, focusing on the following: Options to increase access to private health insurance, including 3 Share programs, employer sponsored plans and portable, individual insurance; Incentives for encouraging counties and local governments to participate in private health insurance cost sharing for their respective residents; Options to reduce health care premiums, including creation of special plans with increased deductibles and catastrophic coverage; Implementation and possible expansion of health services districts; Other state programs for increasing market-based coverage of the uninsured, including costs and effectiveness; Options that will increase consumer choice and personal responsibility; and Analysis of state and federal regulations that contribute to higher premium costs.
3.	Study and make recommendations relating to the Texas Health Insurance Risk Pool, including the current eligibility for coverage requirements, the economic profiles of participants and former participants, the affordability of the insurance products’ premiums and deductibles, and the public's awareness of the Pool.
4.	Study the issue of security and accuracy in Texas elections. The study should include the benefits and risks of electronic voting technology, including the necessity of maintaining a paper record of each electronic vote. The study should also include an analysis of fraud in Texas elections, including prosecution rates for voter fraud, the processes for purging ineligible voters from voter lists, and the integrity of the mail-in and provisional ballot systems. Study the effectiveness of electronic voting technology and voter ID laws in other states. Monitor the implementation of the federal Help America Vote Act of 2002, including the implementation of the Texas Election Administration Management system. Recommend statutory and regulatory changes designed to ensure that only eligible voters are allowed to vote in Texas elections and that each vote is accurately counted.
5.	Review and make recommendations for requiring insurance coverage of routine medical care for patients with a life-threatening disease or condition who have elected to participate in a clinical trial.
6.	Study the economic impact of recent civil justice reform legislation in Texas.
7.	Study whether Texas should adopt the Restatement 2nd of Torts Sec. 674 (Wrongful use of Civil Proceedings) and whether a person should be allowed to recover court and attorneys fees when he has been forced to defend a lawsuit filed without probable cause or for intimidation purposes.
8.	Monitor the Texas workers' compensation system, and the continued implementation of the reforms of HB 7, 79th R.S., by the Texas Department of Insurance and other state agencies. Specifically evaluate the recent decision by the Texas Supreme Court in Entergy v. Summers in terms of its impact and the impact of previous legislation on the workers' compensation system.
9.	Study and make recommendations to reduce illegal gambling in Texas, including, but not limited to, the illegal use of Eight-Liners.
10.	Analyze the advantages and disadvantages of phasing in a defined-contribution pension for future employees versus the existing defined-benefit pension plan. Study options for transition or implementation issues and how the phase-in could be structured. Evaluate the possibility of requiring the state employee contribution rate to meet the annually required contribution for the statewide retirement funds each biennium in order to prevent unfunded liabilities.
11.	Study the relationship between the public mental health system and the criminal justice and civil courts systems, including the identification and sharing of information regarding mentally ill offenders, including minors, among criminal justice and mental health agencies, the courts, state hospitals, and the Veterans Administration. Study how current confidentiality laws impact the exchange of information among groups described above. Study the sentencing of mentally ill offenders compared to non-mentally ill offenders, including minors, and the affect that has on statewide prison capacity and on the quality of health care provided to mentally ill offenders. (Joint charge with Senate Criminal Justice Committee)
12.	Review and evaluate appropriate state regulation of a private operator of the state lottery should the state receive bids for a lease of the lottery that merit strong consideration. Provide recommendations for ensuring the security and integrity of the lottery and for adequate consumer protections. (Joint charge with Senate Finance Committee)
13.	Study the feasibility and the advisability of establishing an investment policy that is consistent across all state trust funds, including the trust funds of the Employees Retirement System, the Teachers Retirement System, the Permanent University Fund, and the Permanent School Fund. Identify best investment policies for state trust funds. Examine recent portfolio diversification strategies and the effect they have on long-term fund performance. The recommendations should consider what is an acceptable rate of return, an acceptable degree of risk, the appropriateness of certain investments. (Joint charge with Senate Finance Committee)
14.	Monitor the implementation of legislation addressed by the State Affairs Committee, 80th R.S., and make recommendations for any legislation needed to improve, enhance, and/or complete implementation. In particular, monitor and report on the effect of HB 2365, 80th R.S., which allows public entities to report "other post employment benefits" (OPEBs) on a statutory modified accrual basis, including any effect on auditor opinions, bond ratings, or other fiscal issues. Monitor the implementation of SB 1731, 80th R.S., relating to transparency of health information, and SB 1846, 80th R.S., relating to TRS.
Committee:	Senate Finance
Title:	Interim Report
Library Catalog Title:	Interim charge recommendations to the 80th Legislature
Subjects:	Banks and banking | Driver Responsibility Program | Emergency medical services | Federal funds | Health care costs | Indigent health care | Medicaid | Medicaid fraud | Money transfers | Transportation planning | Transportation, Texas Department of | Trauma Facilty/EMS account |
Library Call Number:	L1836.79 F49
Session:	79th R.S. (2005)
Online version:	View report [62 pages  File size: 16,186 kb]
Charges:	This report should address the charges below.
1.	Review health care funding, focusing on the Medicaid program, Medicare Part D, hospital reimbursements and trauma and indigent care.
2.	Study the method through which fees are collected under the Driver's Responsibility Program in order in maximize the amount of money for trauma funding and transportation. Look specifically at collection rates and develop means to enhance them.
3.	Determine the number of commercial and consumer transactions, including wire transfers, that occur in Texas. Determine the amount of monies that are sent internationally from Texas. Study the feasibility of creating a pilot program in Harris County that captures a percentage of revenues from such transactions, and request an Opinion from the Attorney General's Office to pursue these revenues as a potential source for health care funding.
4.	Review the process by which the Texas Department of Transportation Commission allocates funds to the districts through the Allocation Program. Include a description of all scoring mechanisms used in making allocations of resources and make recommendations for maximizing the use of these funds to meet Legislative objectives. Joint Charges with Senate Transportation & Homeland Security Committee.
5.	Review the process by which the Texas Department of Transportation Commission determines which federal funding sources should be implemented to comply with funding reductions mandated by Congress. Assess the Commission's options for determining how projects that were to be funded out of these reduced revenue sources will be funded this biennium. Joint Charges with Senate Transportation & Homeland Security Committee.
Committee:	Senate State Affairs
Title:	Interim Report
Library Catalog Title:	Interim report to the 80th Legislature
Subjects:	Child Protective Services | Election fraud | Emergency medical services | Eminent domain | Employees | Employees Retirement System of Texas | Employers | Employment | Health care costs | Health maintenance organizations | Liability | Lobbyists | Medical bill balance billing | Privatization | Public retirement systems | State mandated health insurance | Teacher Retirement System of Texas | Voter identification | Voting by mail | Workers' compensation |
Library Call Number:	L1836.79 St29a
Session:	79th R.S. (2005)
Online version:	View report [211 pages  File size: 6,521 kb]
Charges:	This report should address the charges below.
1.	Study the Employees Retirement System of Texas ("ERS") including the actuarial soundness of the ERS pension fund; the implementation of cost-saving measures in the ERS group health insurance plan; the suggestion of further cost-saving measures such as the implementation of a 3-tiered provider network; the effectiveness of the third party administrator of the ERS group health insurance plan in managing inflation; and the feasibility of consolidating the administration of all state group health plans under a single state agency.
2.	Study the Teachers Retirement System of Texas ("TRS") including the actuarial soundness of the TRS pension fund; the implementation of cost-saving measures in the TRS group health insurance plan; the suggestion of further cost-saving measures such as the implementation of a 3-tiered provider network; the implementation of SB 1370, 79th R.S.; the effectiveness of the third party administrator of the TRS group health insurance plan in managing inflation; and the feasibility of consolidating the administration of all state group health plans under a single state agency
3.	Study and make recommendations on how election officials could verify the identity of a voter without hindering a person's right to vote. Include an analysis of the extent to which individuals are casting multiple votes because of any lack of voter identification verification. Make recommendations on how the state could improve its vote-by-mail system to ensure the authenticity of those ballots.
4.	Monitor the implementation of HB 7, 79th R.S., relating to the workers compensation system of this state.
5.	Study the regulation and management of health care plans, including the following: Study the reimbursement methodology of health care plans for out-of-network claims, the adequacy of health plan networks to provide appropriate coverage, the impact of out-of-network balance billing by physicians and health care providers and the accurate disclosure of patients' out-of-pocket costs. Study the discounting and/or waiving of co-pays, deductibles and co-insurance by physicians and health care providers. Specifically, how this practice can impact the cost to private and public health plans and the impact to acute, multi-service hospitals, including safety net hospitals. Evaluate health care cost transparency by health care providers and access to that information by patients. Review data reported to the Texas Department of Insurance by health care plans, investigate possible expansion of health plans' reportable data, including, but not limited to, administrative costs, and what, if any, is the appropriate release and publication of that information.
6.	Study and review current law on the doctrine of eminent domain, including the U.S. Supreme Court case in Kelo v. City of New London. Monitor the implementation of SB 7, 79th Legislature, 2nd Called Session, and make any necessary recommendations as to the use of eminent domain for economic development purposes and the issue of what constitutes adequate compensation for property taken through the use of eminent domain. Determine whether a constitutional amendment is prudent and/or necessary to protect private property owners from condemnations for economic development purposes. Determine which state, regional, and local governmental entities have eminent domain powers and how those powers may be used. Make recommendations regarding their necessity, fairness, and effectiveness. Study the public policy implications relating to Chapter 2007, Government Code, Private Real Property Rights Preservation Act, its effectiveness in protecting private property rights, and the current impact of regulatory takings on private property owners.
7.	Study the costs associated with mandates to insurance companies for increased coverage for specific illnesses, medical conditions, or diseases, including obesity. Provide a cost assessment of the impact of such mandates to the state and local units of government. Include data and analysis of the costs and medical impact associated with insurance mandates which have been enacted in other states, as well as any short- and long-term cost-savings. Develop recommendations on how to provide increased cost-effective coverage, especially to populations with impairments and diseases, as well as the underinsured/uninsured.
8.	Study the prevalence, legality and ethics of entities that actively lobby the Legislature to impact the lawmaking process while that entity is in any way a recipient of state funds.
9.	Study and make recommendations regarding the cost drivers of emergency medical services. Make recommendations on how to improve and sustain EMS services for Texas, as well as reduce costs to health care plans, businesses, and individuals.
10.	Study and review current Texas law on the doctrine of statutory employer, including the 2004 First District Court of Appeals' decision in Etie v. Walsh & Albert Co. and make recommendations of changes in state laws, if necessary, regarding the doctrine of statutory employer and indemnification in construction contracts. Study the current use of Consolidated Insurance Programs and make legislative recommendations, if appropriate.
11.	Assess the benefit of limiting the civil liability for noneconomic damages against non-profit organizations involved in the privatization of child welfare services.
Committee:	Senate Finance
Title:	Interim Report - General Government, Public Safety and Economic Development
Library Catalog Title:	Interim report of the Senate Finance Committee : recommendations to the 79th Legislature.
Subjects:	Economic development incentives | Fees | Health care costs | Licensing and Regulation, Texas Department of | Prison population | Prisons | Texas Enterprise Fund |
Library Call Number:	L1836.78 F49 v. 2
Session:	78th R.S. (2003)
Online version:	View report [219 pages  File size: 9,919 kb]
Charges:	This report should address the charges below.
1.	Natural Resources & Economic Development Fund 006. Review revenue sources into and appropriations out of Fund 006. Review policy decisions by the 78th Legislature that will impact the future of the Fund. Make recommendations for improvement, as needed. Enterprise Fund. Monitor and report on current and potential future uses of the Enterprise Fund. Study and develop recommendations for using economic development funds and assessing potential projects, including, but not limited to, establishing criteria for investment, developing standards for cost-benefit analyses, leveraging local participation, and incorporating claw-back provisions if goals are not met.
2.	General Government, Regulatory, & Judiciary Review of Fees. Conduct comprehensive review of and report on fees at state regulatory agencies, including historical information on fee amount, expenditures, appropriations, populations affected and general impact to the state budget. Revisit Rising Health Care Cost Study of the 77th Legislature. Review the cost study and determine which cost elements of the study have not been controlled and make recommendations to the 79th Legislature to address bringing them under control. Examine the budget impact of policy decisions of the 78th Legislature and make recommendations for improvement.
3.	Criminal Justice & Public Safety Adult and Juvenile Correction Populations. Monitor population trends in the adult and juvenile correction facilities and determine if budget decisions made in the 78th Legislature remain viable. Make recommendations for improvement, as necessary.
Committee:	Senate Workers' Compensation, Select, Interim
Title:	Interim Report
Library Catalog Title:	Report to the 79th Legislature
Subjects:	Health care costs | Workers Compensation Commission, Texas | Workers' compensation |
Library Call Number:	L1836.78 W892s
Session:	78th R.S. (2003)
Online version:	View report [235 pages  File size: 1,581 kb]
Charges:	This report should address the charges below.
1.	Examine the status of the Health Care Network Advisory Committee's (HNAC) and the Texas Workers' Compensation Commission's implementation of the regional workers' compensation health care delivery networks outlined in Article 2 of HB 2600, 77th R.S. (2001).
2.	Study the potential impact of networks on the workers' compensation health care delivery system. Include in the study: a. Quality of care; b. Network adequacy and access to care; c. Disclosure of information to patients, complaint procedures, appeal rights and overall patient satisfaction; d. Costs of care; e. Provider credentialing, selection and dispute resolution; f. Financial risks to providers, employers and carriers; g. Effects of networks on the Texas Workers' Compensation Commission; and h. Quality monitoring systems such as independent report cards.
3.	Study the impact of the Texas Workers' Compensation Commission's 2002 Medical Fee Guideline on access to quality medical care for injured workers and medical costs, including recommendations on whether the legislature should statutorily prescribe a methodology for calculating the workers' compensation conversion factor.
4.	Conduct a cost-benefit analysis, to the extent possible, comparing the Texas workers' compensation system to systems operating in other states. Make recommendations to improve the quality of care for injured workers, reduce fraud and inefficiencies, reduce overall claim costs, and streamline the administration of the system. Recommendations should address data exchange, advisory groups and review panels, dispute resolution, enforcement issues, paperwork reduction, and billing and administrative efficiencies.
5.	Study the efficiency and effectiveness of the state's workers' compensation system including a comparison of the medical and indemnity costs associated with the Texas A&M University system, the Texas Department of Transportation and the State Office of Risk Management. Evaluate the potential costs and benefits associated with state agency participation in workers' compensation networks.
6.	Survey the costs and benefits of other health system cost-containment strategies as they relate to medical, therapeutic, and pharmaceutical care, including but not limited to, doctor selection, deductibles, co-payments, preauthorization of services, and return-to-work programs.
7.	Study and make recommendations relating to the pricing of workers' compensation insurance premiums in Texas, including, but not limited to, the impact of rating tools such as schedule rating, negotiated experience modifiers, negotiated deductibles and underwriting.
Committee:	Senate Finance
Title:	Interim Report - rising medical costs
Library Catalog Title:	Interim report / Senate Finance Subcommittee on Rising Medical Costs.
Subjects:	Health care costs |
Library Call Number:	L1836.77 F49MC
Session:	77th R.S. (2001)
Online version:	View report [128 pages  File size: 3,060 kb]
Charge:	This report should address the charge below.
1.	Study the issue of rising medical costs and its impact on the state budget, including health and human services, correctional managed health care, education and state employee benefits. The Committee may review private pay insurance. The Committee's report should recommend ways to control cost increases and identify best practices and opportunities for savings.
Committee:	Joint Employee Benefits, Select
Title:	Interim report
Library Catalog Title:	Report of the Joint Select Committee on Employee Benefits to the 72nd Legislature.
Subjects:	Employees Retirement System of Texas | Health care costs | Health insurance | Teacher health insurance | Teacher Retirement System of Texas |
Library Call Number:	L1836.71 em73
Session:	71st R.S. (1989)
Online version:	View report [162 pages  File size: 6,142 kb]
Charge:	This report should address the charge below.
1.	Study the administration of employee health insurance programs, including those programs administered by institutions of higher education; issues related to the state contribution to health insurance premiums; and issues relating to the structure, administration, and financing of employee retirement systems. The study shall include, but not be limited to, a review of the competitive process for the selection of health care providers, cost containment measures and their implementation, administrative or legislative actions that may have contributed to increased costs or reduced benefits in health care coverage, the interpretation and implementation of statutorily mandated uniformity of benefits, changes in the administrative structure of health insurance programs, and, in regard to retirement systems, the methodology and accuracy of actuarial analysis, the transferability of retirement benefits among systems, and the method of calculation of the state contribution to the employees' pension funds.
Supporting documents
Committee:	Joint Employee Benefits, Select
Title:	Proclamation
Library Catalog Title:	Proclamation
Library Call Number:	L1800.1 p926
Session:	71st R.S. (1989)
Online version:	View document [1 pages  File size: 120 kb]
Committee:	House Public Health
Title:	Interim report
Library Catalog Title:	To the Speaker and members of the Texas House of Representatives, 69th Legislature : report of the Committee on Public Health.
Subjects:	Alcohol-related deaths | Alcoholism | Alternative medicine | Border health | Health care costs | Indigent health care | Mental health services | Mentally ill persons | Psychologists | South Texas |
Library Call Number:	L1836.68 h349
Session:	68th R.S. (1983)
Online version:	View report [31 pages  File size: 1,116 kb]
Charges:	This report should address the charges below.
1.	To study, in cooperation with the House-Senate Joint Committee in Indigent Health Care, health care needs in South Texas.
2.	To study chelation therapy, acupuncture, and the practice of human ecology, in cooperation with the House Committee on Human Services.
3.	To study alcoholism in women.
4.	To study the role of psychologists in mental health commitment process and in the delivery of health services.
5.	Study the issues of rising medical costs and medical cost containment. *
Committee:	Senate Medical Costs, Interim
Title:	Interim Report
Library Catalog Title:	Report to the Sixty-third Legislature. / Senate Interim Committee to Study Rising Medical Costs.
Subjects:	Health care costs | Health maintenance organizations | Medical reimbursements |
Library Call Number:	L1836.62 M468r
Session:	62nd R.S. (1971)
Online version:	View report [24 pages  File size: 1,087 kb]
Charge:	This report should address the charge below.
1.	Make a thorough study of rising medical costs.
Committee:	Senate Insurance
Title:	Interim Report
Library Catalog Title:	A report to the 62nd Legislature / by the Interim Senate Insurance Study Committee as authorized by S.R. 834, 61st Legislature, 1969.
Subjects:	Health care costs | Health insurance | Insurance industry |
Library Call Number:	L1836.61 in7
Session:	61st R.S. (1969)
Online version:	View report [38 pages  File size: 1,423 kb]
Charge:	This report should address the charge below.
1.	Investigate the facts surrounding the practices of health, accident, and hospitalization insurance companies in dealings with policyholders and the general public in order to determine whether legislation might be needed to protect the public as well as the insurance industry in general.
Committee:	Joint Emergency Hospital Treatment
Title:	Interim Report
Library Catalog Title:	Report of the Joint Interim Committee on Emergency Hospital Treatment.
Subjects:	Emergency medical services | Health care costs |
Library Call Number:	L1836.60 em32
Session:	60th R.S. (1967)
Online version:	View report [39 pages  File size: 1,738 kb]
Charge:	This report should address the charge below.
1.	Make a study of the problems of and facilities for emergency treatment of indigent patients in public and nonpublic hospitals of Texas.

* This represents an abstract of the report contents. Charge text is incomplete or unavailable.

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