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 can only contract with MCOs that have been certified, demonstrate financial solvency, and comply with performance measures. The bill outlines the necessary contract provisions, readiness review requirements, and the programs affected, including STAR, CHIP, STAR Kids, and STAR + PLUS, while explicitly excluding the STAR Health program. Additionally, it mandates that recipients can select any MCO in good standing that has a contract with the commission.

Furthermore, the bill introduces performance measures for evaluating MCOs based on cost efficiency, quality of care, and member satisfaction, among other criteria. It specifies that the commission must publish these measures and conduct annual evaluations, making the results publicly accessible. The bill also modifies existing provisions regarding health plan providers, requiring them to be contracted through the Managed Care Consumer Choice Program starting September 1, 2027, and establishes a timeline for transitioning contracts with MCOs for various programs. The act will take effect immediately upon receiving a two-thirds vote or on September 1, 2025, if not.

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