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 Health and Human Services Commission to contract with managed care organizations to provide health care services to recipients. The commission is required to issue requests for applications and ensure that any organization contracted meets specific criteria, including financial solvency and compliance with performance measures. The bill outlines the necessary contract provisions, readiness reviews, and the programs affected, which include STAR, CHIP, STAR Kids, and STAR + PLUS, while explicitly excluding the STAR Health program. Additionally, it provides the commission with remedies for non-compliance by managed care organizations.

Furthermore, the bill introduces Section 533.0036, which mandates the establishment of quality and performance measures for evaluating managed care organizations based on their experience in the Texas Medicaid and CHIP market. The commission is tasked with annual evaluations of these organizations and must publish the results in an accessible format. The bill also amends 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. The Health and Human Services Commission is directed to begin requesting applications for this program by September 1, 2026, and to extend existing contracts until new ones are established.

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