HBA-MPM S.B. 1394 77(R)    BILL ANALYSIS


Office of House Bill AnalysisC.S.S.B. 1394
By: Fraser
Insurance
5/7/2001
Engrossed



BACKGROUND AND PURPOSE 

The statewide rural health care system (RHCS) is the state-designated rural
health care system created by the 75th Legislature in 1997.  While the
legislature appropriated no funding for the system during that session or
the subsequent session in 1999, the system has coordinated with private
sector program partners to create a model for a viable rural health care
system.  Allowing RHCS to participate in a voluntary Medicaid demonstration
could enable RHCS to implement the model, which emphasizes preventive care,
disease management, care coordination, and quality improvement and which
could extend health care services to uninsured individuals who live in
rural communities.  Senate Bill 1394 authorizes the commissioner of health
and human services to use RHCS for a voluntary pilot or demonstration
program for Medicaid and a study of the use of promotoras. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate additional rulemaking authority to a state officer,
department, agency, or institution. 

ANALYSIS

Senate Bill 1394 amends the Insurance Code to authorize the commissioner of
health and human services to use the statewide rural health care system
(RHCS) for a voluntary pilot or demonstration program that evaluates the
use of an insured model for beneficiaries of a medical assistance program
in a rural area that is not currently included in an existing Medicaid
managed care pilot program area and that incorporates the principles of
prevention and disease management and for a study of the use of promotoras
(Art. 20C.14). 

The bill provides that RHCS  is established and authorized to sponsor,
arrange for, or provide health care services for programs in rural areas
that are not subject to: 

_a law requiring coverage or the offer of coverage for services by a
particular health care provider under the state child health plan (CHIP),
Medicaid, any state, county, or local government sponsored indigent care
initiative, or any federal Medicare Plus Choice program; or 

_provisions governing group and blanket accident and health insurance under
any state, county, or local government sponsored uninsured or indigent care
initiative (Art. 20C.03). 

The bill provides that if RHCS seeks to sponsor, arrange for, or provide
such health care services under a private or commercial program, RHCS must
comply with all requirements under the Insurance Code imposed on health
plans, including health maintenance organizations, except the requirements
the commissioner of insurance determines are inapplicable to RHCS relating
to mileage, distance, network adequacy, and scope of coverage and any
additional requirements the commissioner determines necessary to ensure
enrollees access to health care providers and services (Art. 20C.04). 

The bill removes the requirement that the governor appoint 12 members of
the board of directors of RHCS  (board), and requires these board members
to be appointed in accordance with the bylaws of RHCS (Art. 20C.06).  The
bill also modifies the goals of RHCS (SECTION 1). 

EFFECTIVE DATE

September 1, 2001.