Bill Text: TX HB2626 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to administrative and other expenditures by Medicaid managed care organizations.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2017-04-24 - Left pending in committee [HB2626 Detail]
Download: Texas-2017-HB2626-Introduced.html
85R11092 LED-D | ||
By: Muñoz, Jr. | H.B. No. 2626 |
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relating to administrative and other expenditures by Medicaid | ||
managed care organizations. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter A, Chapter 533, Government Code, is | ||
amended by adding Section 533.021 to read as follows: | ||
Sec. 533.021. ADMINISTRATIVE AND OTHER EXPENDITURES. (a) | ||
The legislature, after consulting with the commission, may set in | ||
the General Appropriations Act an upper limit on the percentage or | ||
amount of Medicaid capitated or other premium payments that a | ||
managed care organization offering a Medicaid managed care plan may | ||
spend on administrative, overhead, and marketing costs in each year | ||
of the state fiscal biennium. | ||
(b) Not later than December 1 of each year, a managed care | ||
organization offering a Medicaid managed care plan shall report to | ||
the legislature and the commission the percentage of the managed | ||
care organization's budget that the managed care organization spent | ||
during the preceding state fiscal year on: | ||
(1) administrative, overhead, and marketing costs; | ||
and | ||
(2) reimbursement for clinical services provided to | ||
enrollees, activities that improve health care quality for those | ||
enrollees, and all other activities related to those enrollees. | ||
SECTION 2. If before implementing any provision of this Act | ||
a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 3. This Act takes effect immediately if it receives | ||
a vote of two-thirds of all the members elected to each house, as | ||
provided by Section 39, Article III, Texas Constitution. If this | ||
Act does not receive the vote necessary for immediate effect, this | ||
Act takes effect September 1, 2017. |