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 to provide health care services to recipients. The commission is required to issue requests for applications and ensure that any organization it contracts with is certified, financially solvent, and compliant with performance measures. The bill outlines specific criteria for contracts, including readiness reviews and the inclusion of necessary provisions, and it mandates that recipients can select any managed care plan in good standing within their service delivery area.

Additionally, the bill introduces Section 533.0036, which requires the commission to establish quality and performance measures for evaluating managed care organizations based on their experience in the Texas Medicaid and CHIP market. It also specifies that the commission must publish selection criteria for managed care organizations and evaluate their performance annually. The bill further amends Section 62.155 of the Health and Safety Code to stipulate that starting September 1, 2027, health plan providers will be contracted through the Managed Care Consumer Choice Program rather than through a competitive procurement process. The bill sets a timeline for the implementation of these changes, with contracts for certain programs to be established by September 1, 2027, and September 1, 2030, for others.

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