The bill, titled "Managed Care Consumer Choice Program," amends the Government Code by adding Sections 533.0021 and 533.0022, which establish a framework for the Texas Health and Human Services Commission to contract with managed care organizations (MCOs) to provide health care services to recipients. The commission is required to issue requests for applications and ensure that MCOs meet specific criteria, including financial solvency and compliance with performance measures. Contracts must include necessary provisions and cannot take effect until the MCOs complete a readiness review as mandated by federal law. The bill also outlines the programs affected, which include STAR, CHIP, STAR Kids, and STAR + PLUS, while excluding the STAR Health program.

Additionally, the bill introduces Section 533.0036, which mandates the establishment of quality and performance measures for evaluating MCOs based on their experience in the Texas Medicaid and CHIP market. The commission is tasked with annually assessing MCO performance and making the results publicly accessible. Furthermore, the bill modifies Section 62.155(a) of the Health and Safety Code to require that health plan providers be contracted through the Managed Care Consumer Choice Program starting September 1, 2027, rather than through a competitive procurement process. The bill also sets timelines for the Health and Human Services Commission to begin requesting applications and entering contracts, with specific deadlines for the STAR and CHIP programs by September 1, 2027, and for STAR Kids and STAR + PLUS by September 1, 2030.

Statutes affected:
Introduced: Health and Safety Code 62.155 (Health and Safety Code 62)