The bill, H.B. No. 5184, introduces the Managed Care Consumer Choice Program by amending the Government Code to add Sections 533.0021 and 533.0022. This program allows the Health and Human Services Commission to issue requests for applications to contract with managed care organizations to provide health care services to recipients. The bill outlines specific requirements for these organizations, including certification, financial solvency assurances, and compliance with performance measures. It also mandates that the commission ensure recipients can select any managed care plan in good standing and establishes remedies for non-compliance by managed care organizations.

Additionally, the bill amends Section 62.155 of the Health and Safety Code to require that, starting September 1, 2027, the commission will contract with health plan providers through the Managed Care Consumer Choice Program rather than through a competitive procurement process. The bill sets a timeline for the commission to begin requesting applications and entering contracts, with a focus on ensuring continuity of care for recipients during the transition to the new program. It also includes provisions for the extension of existing contracts and the cancellation of pending procurements for certain 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)