HBA-MPM C.S.H.B. 2236 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 2236 By: Gray Public Health 34/6/1999 Committee Report (Substituted) BACKGROUND AND PURPOSE The University of Texas Medical Branch (UTMB) at Galveston has for more than 100 years provided health care for individuals who have no insurance and cannot pay for their health care. Last year, UTMB served uninsured children and adults from 235 Texas counties, at a cost of more than $142 million in charity care. State and federal changes to Medicaid and Medicare reimbursement resulted in decreases in reimbursement to UTMB of more than $28 million, thereby hindering the facility's ability to care for indigent Texans. C.S.H.B. 2236 allows UTMB to contract with certain state agencies, including the Texas Department of Health and the Texas Department of Human Services, to be one of the HMOs to provide managed care services to certain populations of Texans. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 533.004(a), Government Code, to specify that in providing health care services through Medicaid managed care to recipients in a health care service region, the Health and Human Services Commission is required to contract with a managed care organization, rather than at least one managed care organization, in that region that meets certain specifications. Includes among a list of specifications that a managed care organization holds a certificate of authority under Article 20A.05 (Issuance of Certificate of Authority), Insurance Code, and that is certified under Section 5.01(a), Article 4495(b), V.T.C.S. (Medical Practice Act), and that it is created by the University of Texas Medical Branch at Galveston. Describes for the purposes of a managed care organization described by this section: "health care service region" or "region." Redesignates existing Subdivisions (1)-(3) to Paragraphs (A)-(C), and existing Paragraphs (A) and (B) to Subparagraphs (i) and (ii), respectively. SECTION 2.Emergency clause. Effective date: upon passage. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 2236 modifies the original bill in SECTION 1 (Section 533.004, Government Code), by requiring that the Health and Human Services Commission contract with any managed care organization in that region, rather than "a managed care organization," in providing health care services through Medicaid managed care to recipients in a health care service region, to meet certain requirements. Additionally, this substitute modifies the original by including in proposed Subdivision 533.004(a)(2) among a list of specifications that a managed care organization hold a certificate of authority under Article 20A.05 (Issuance of Certificate of Authority), Insurance Code, rather than Article 21.52F (Right to Select Practitioner Under Health and Accident Policies), Insurance Code, and that meets certain certification requirements. Additionally, the substitute also adds new Subsection (e) to include the definitions of "health care service region" or "region" for purposes of this section.