HBA-DMH H.B. 2470 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2470 By: Chavez Public Health 3/13/2001 Introduced BACKGROUND AND PURPOSE Residents in the Texas-Mexico border region suffer from inadequate medical services compared with most Texans. Physician to patient ratios are lowest along the border region an in rural areas and inner cities. In February 2000, the Health and Human Services Commission (HHSC) convened the Border Rate Work Group (work group) to study and recommend solutions regarding Medicaid and the state child health plan (CHIP) reimbursement rates along the Texas-Mexico border. The work group concluded that a lack of access to health care services along the border has reduced the utilization rates of health care services in the region, that the border region receives disproportionately low reimbursement as a result of low utilization rates, and that Medicaid and CHIP capitation rates do not reflect the current health care environment since they are based on past fee for service reimbursement rates. The report also found that lower revenue provides a disincentive for health care providers to locate and remain in the border region. The work group recommended increasing Medicaid and CHIP reimbursement rates in this region to recruit more doctors and increase access to care. House Bill 2470 requires HHSC to increase Medicaid and CHIP reimbursement rates for recipients in the Texas-Mexico border region to an adjusted statewide average and provides physicians with a 10 percent bonus for providing services in the region. 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 2470 amends the Government Code to require the commissioner of health and human services (commissioner) to appoint an advisory committee (committee) to develop a strategic plan for eliminating the disparities between the Texas-Mexico border region and other areas of the state in certain Medicaid and state child health plan (CHIP) rates and expenditures. The bill sets forth provisions for the appointment, administration, and operation of the committee. The bill requires the committee to perform the research necessary to analyze and compare the rates and expenditures, and produce a report based on the results of that analysis and comparison. The bill requires the committee to make recommendations for addressing the problems created by disparities documented in the report. With advice from committee, the bill requires the Health and Human Service Commission (HHSC) to ensure that: _the disparities in rates and expenditures are eliminated as soon as practicable so that the rates and expenditures in the Texas-Mexico border region equal those statewide; _a physician providing a service to a Medicaid recipient in the Texas-Mexico border region receives a bonus in the amount of 10 percent of the reimbursement customarily provided to a physician providing that services in another region of the state. The bill requires HHSC to exclude data from the Texas-Mexico border region in determining statewide average rates and expenditures. With advice from the committee and other appropriate groups, the bill authorizes HHSC to vary the amount of any rate increases for professional services according to the type of service provided. The bill requires HHSC to develop mechanisms to pass any rate increase directly to providers. The bill requires HHSC to contract with a public university to: _measure changes occurring from September 1, 2001, to August 31, 2004, in the number of health care providers participating in the Medicaid or CHIP in the Texas-Mexico border region and resulting effects on consumer access to health care and consumer utilization; _determine any effects of the changes in rates and expenditures; and _submit a report to the legislature, not later than December 1, 2004. The bill provides that these provisions expire September 1, 2011, and that the changes in rates and expenditures must be initiated by September 1, 2002. EFFECTIVE DATE September 1, 2001.