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 meet specific criteria, including certification of financial solvency and compliance with performance measures. The bill outlines the necessary contract provisions, readiness review requirements, and the programs affected, which include STAR, CHIP, STAR Kids, and STAR + PLUS, while explicitly 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 publishing selection criteria for MCOs and conducting annual performance evaluations, with results made publicly accessible. The bill also modifies Section 62.155 of the Health and Safety Code to require that starting September 1, 2027, health plan providers be contracted through the Managed Care Consumer Choice Program rather than through a competitive procurement process. The implementation timeline includes a requirement for the commission to begin requesting applications by September 1, 2026, and to enter into contracts for various programs by specified deadlines.

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