TITLE: Relating to transparency in the STAR Medicaid managed care rate-setting process.

SUMMARY: Relating to transparency in the STAR Medicaid managed care rate-setting process.

FULL TEXT:
AN ACT relating to transparency in the STAR Medicaid managed care rate-setting process. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subchapter A, Chapter 533, Government Code, is amended by adding Section 533.01314 to read as follows: Sec. 533.01314. TRANSPARENCY OF PREMIUM PAYMENT RATE-SETTING PROCESS FOR STAR MEDICAID MANAGED CARE PROGRAM. The commission shall ensure the transparency of the premium payment rate-setting process for the STAR Medicaid managed care program by publishing actuarial reports: (1) in a format that allows for tracing data and formulas across attachments, exhibits, and examples; and (2) that clearly identify and describe: (A) the methodology by which the executive commissioner set the payment rates; (B) the data sources used; (C) the components of the process that are assumptions and how the assumptions are developed; and (D) multipliers and factors used throughout the reports, including the source and purpose of the multipliers and factors. SECTION 2. If before implementing any provision of this Act a state agency determines that authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the authorization and may delay implementing that provision until the authorization is granted. SECTION 3. This Act takes effect September 1, 2015.