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


Office of House Bill AnalysisH.B. 1516
By: Janek
Public Health
3/6/2001
Introduced



BACKGROUND AND PURPOSE 

Patients with catastrophic health problems, such as organ transplants or
multiple traumas, represent only a small number of the total medical
assistance program patient load, but they account for a very large portion
of the medical assistance program's 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 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 medical assistance 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 medical assistance to
persons with catastrophic health problems. The bill establishes that the
system must provide for the assignment of a case manager to a recipient of
medical assistance 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 odd-numbered 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.