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Austin, Texas 78711
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MEDICAID REFORM SENT TO GOVERNOR'S DESK
AUSTIN -- A conference committee has worked out differences between the House and Senate versions of SB 10 by State Senator Jane Nelson, R-Lewisville, reforming Medicaid and helping to reduce the rate of Texans without health insurance. The bill next moves to the governor's desk.
"This legislation lays the foundation for a new approach to health care for the poor, the fragile and the uninsured," Senator Nelson said, noting that Medicaid costs Texas taxpayers $17.9 billion a year. "It expands our efforts to assist with premiums for the uninsured, discourages inappropriate visits to the emergency room, and focuses heavily on preventive health, which will help contain our acute care costs over the long term and, more importantly, help Texans maintain good health."
Medicaid Reform Provisions of SB 10
- Rewards Medicaid patients who complete smoking cessation, weight loss and other preventative health programs;
- Encourages Medicaid managed care plans to enroll patients in "value-added" preventative health services;
- Creates customized benefit plans that are tailored to a patient's individual health care needs;
- Creates a pilot program for Health Savings Accounts under Medicaid, which would be completely optional;
- Expands the effort to assist with the cost of premiums for those who are Medicaid-eligible but have access to employer-based plans;
- Expands efforts to stop fraud and abuse;
- Authorizes co-pays for non-emergency visits to hospital emergency rooms, providing that there are alternative health care options available;
- Standardizes the way hospitals report uncompensated care to eliminate guesswork involved in the state's cost projections; and
- Evaluates possible expansion of integrated care management to areas where it is currently unavailable.
SB 10 Provisions on the Uninsured:
- Develops a model in which regional partnerships can be created to allow the state, employers and local governments or charitable entities to join together in efforts to connect Texans with health coverage;
- Creates a committee to recommend incentives for more employers to offer health and long-term care insurance;
- Establishes a low income funding pool that could be used to set aside a portion of federal uncompensated care dollars to connect low-income families with private health care.
Highlights of Key Additions Made in Conference:
- SB 1696 by Senator Nelson was added as an amendment in the House. It expands access to breast and cervical cancer screenings and treatment for women under Medicaid;
- Extends Medicaid services to former foster children who are enrolled in higher education up to age 23;
- Allows HHSC to implement health IT for the medical assistance program and another allowing a health IT pilot program for Medicaid providers;
- Directs a study into ways to increase the number of medical residency programs in Texas; and
- Maintains the Medicaid Reform Legislative Oversight Committee.
SENATOR JANE NELSON represents District 12, which includes parts of Tarrant and Denton counties. She is Chairman of the Senate Health & Human Services Committee.