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No significant fiscal implication to the State is anticipated associated with the analysis and reporting requirements of the bill. However, the fiscal implications of the bill that may occur as a result of new rates for the Program of All Inclusive Care for the Elderly cannot be determined at this time because it is unknown whether they would be higher or lower than current rates, and by what amount.
No fiscal implication to units of local government is anticipated.
This bill is substantively the same as when we reported on it in its original chamber. We continue to remain neutral on HB 3823. The second chamber sponsor is Senator Rodriguez.
Original chamber analysis below:
The bill would require the executive commissioner of the Health and Human Services Commission (HHSC) to establish reimbursement rates for the Program of All-Inclusive Care for the Elderly (PACE). The HHSC executive commissioner would have to confirm the reimbursement rates for providers under PACE are adequate and do not exceed the reasonable and necessary costs to operate PACE. PACE would need to be cost-neutral in comparison to the STAR + PLUS Medicaid managed care program.
The bill instructs HHSC to consider collecting historical cost and utilization data from PACE providers. The bill would direct HHSC and the Department of Aging and Disability Services (DADS) to modify data collection methods for PACE and STAR+PLUS to allow for a comparison of client outcomes across these models.The bill would also direct HHSC and DADS to evaluate costs and client outcomes in PACE and STAR+PLUS and submit a report to the Legislative Budget Board and the Office of the Governor by December 1, 2016. The evaluation would need to compare similar recipient types between the programs and account for geographic differences and recipient acuity. If HHSC cannot set reimbursement rates in accordance with the above requirements, the report would also include an assessment of future cost implications to the state for the PACE program.
The purpose of the legislation is to establish a reimbursement methodology and reporting requirement for the PACE program. The fiscal note indicates that the fiscal impact of any potential changes in PACE rates cannot be determined at this time because it is unknown whether new rates would be higher or lower than current PACE rates.
Since the future fiscal impact is unknown, there is no basis to determine how this legislation would affect our limited government principle. We remain neutral on HB 3823.