HBA-NRS H.B. 1516 77(R)BILL ANALYSIS


Office of House Bill AnalysisH.B. 1516
By: Janek
Public Health
77/16/2001
Enrolled



BACKGROUND AND PURPOSE 

Patients with catastrophic health problems, such as organ transplants or
multiple traumas, represent only a small number of the total Medicaid
patient load, but they account for a very large portion of Medicaid
expenses. Such patients require multiple, specialized providers of health
care and expensive medical procedures. The rapid assignment of a case
manager to a patient with catastrophic health problems will likely result
in the patient receiving the most appropriate and cost-effective services
and will likely prevent the patient from missing out on needed financial
and medical services. Case managers routinely make arrangements with
medical facilities, sort out travel and lodging options, contact support
groups, and educate patients and their families about the nature of the
patient's illness or injury.  House Bill 1516 requires the Health and Human
Services Commission to develop and implement a catastrophic case management
system to be used in providing Medicaid  to persons with catastrophic
health problems. 

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. 

ANALYSIS

House Bill 1516 amends the Human Resources Code to require the Health and
Human Services Commission (HHSC) to develop and implement a catastrophic
case management system to be used in providing Medicaid to persons with
catastrophic health problems. The bill establishes that the system must
provide for the assignment of a case manager to a Medicaid recipient with
catastrophic health problems that are likely to require the service of
multiple, specialized health care providers and result in major medical
costs. The bill requires HHSC to identify the services to be provided by a
case manager, including assessment of the recipient's needs, coordination
of all available medical services, and payment options. The bill also
authorizes and sets forth other support services.  Not later than January
15 of each oddnumbered year, the bill requires HHSC to report to the
legislature on the implementation of the system. The report must include a
statement of the number of recipients of medical assistance who received
catastrophic case management services under the system during the preceding
two years and the estimated savings resulting from implementation of the
system during  the preceding two years. 

EFFECTIVE DATE

September 1, 2001.