HBA-JLV S.B. 284 77(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 284 By: Nelson Public Health 5/15/2001 Engrossed BACKGROUND AND PURPOSE The current Medicaid managed care reporting system can be onerous and difficult to navigate due to the number of health plans involved in the delivery of services. Senate Bill 284 requires the Health and Human Services Commission to study methods to streamline the reports required of health care providers to reduce the administrative burden placed on providers' practices, and to make recommendations to implement certain practices. The bill also requires relevant agencies to establish interagency memoranda of understanding and a single audit instrument. 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 Senate Bill 284 amends the Government Code to require the Health and Human Services Commission (HHSC) to: _evaluate on-site inspection procedures of managed care organizations contracting with the HHSC under the Medicaid managed care program; _evaluate methods to streamline those procedures to assist HHSC in determining necessary and effective quality control measures and required data; _evaluate methods to streamline reporting requirements for such managed care organizations; and _require such managed care organizations to evaluate reporting requirements for health care providers to identify methods of reducing the administrative burden placed on the providers. The bill requires HHSC to submit a report to the legislature not later than November 1, 2002, regarding the evaluation of and methods for streamlining on-site inspection procedures and reporting requirements for managed care organizations and health care providers providing health care services to recipients. The bill provides that the report must include recommendations on which methods should be implemented and a schedule for implementation. The bill provides that the provisions regarding evaluation of reporting requirements and inspection procedures expire September 1, 2002. The bill provides that HHSC shall require a health and human services agency implementing the Medicaid managed care program to provide to each other health and human services agency implementing the Medicaid managed care program information reported to that agency by a managed care organization or health care provider providing services to recipients. The bill requires the chief executive officers of HHSC, the Texas Department of Insurance (TDI), and, if appropriate, health and human services agencies, to execute and provide to all Medicaid health maintenance organizations (HMOs) interagency memoranda of understanding that maximize interagency coordination and eliminate existing and prevent future duplicative monitoring, regulation, and enforcement policies and processes. The bill requires HHSC and TDI to develop a single audit instrument to be used by HHSC, health and human services agencies and their contractors, and TDI and their contractors for regularly scheduled, comprehensive, on-site readiness, performance, compliance, or other reviews, audits, and examinations of Medicaid HMOs, and specify in detail the process the agencies shall use to amend the single audit instrument. The bill requires HHSC and TDI to complete the interagency memoranda of understanding and the single audit instrument not later than November 30, 2001. EFFECTIVE DATE On passage, or if the Act does not receive the necessary vote, the Act takes effect September 1, 2001.