HB 1159

83(R) - 2013

Vote Recommendation

  • Neutral
  • Neutral
  • Neutral
  • Positive
  • Neutral


Lois Kolkhorst

Bill Caption

Relating to a utilization review process for managed care organizations participating in the STAR + PLUS Medicaid managed care program.

Fiscal Notes

Estimated Two-year Net Impact to General Revenue Related Funds for HB1159, Committee Report 1st House, Substituted: an impact of $0 through the biennium ending August 31, 2015. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.

Bill Analysis

Summary:  HB 1159 would require the Office of Contract Management (office) within the Health and Human Services Commission to investigate and review each managed care organizations (MCO) procedures for determining whether a Medicaid beneficiary should be enrolled in a STAR+PLUS home and community-based services and supports program. The office is required to review every contract or only those MCOs with a higher likelihood of inappropriate client placement based on a risk-based assessment process. The office must report to the Legislature on its findings each year and HB 1159 stipulates that if a service review results in a decision to recoup money from an MCO, a service provider that contracted with such an MCO cannot be held liable for the good faith provision of services based on authorization from the MCO that is recouped.

Analysis: HB 1159 requires more stringent oversight of MCOs to determine those MCOs that are putting Medicaid clients into STAR+PLUS when they should not be. STAR+PLUS is an expensive program that must be reserved for those beneficiaries that need it most. If this oversight ensures only those needing to be in STAR+PLUS are in the program, HB 1159 will save taxpayer resources and limit the amount of taxpayer dollars put toward unnecessary or inappropriate care. Support HB 1159.