TX HB5183

Managed care organization contracts under Medicaid (STAR, STAR Kids, STAR+Plus) and the Children's Health Insurance Program (CHIP) will have no set term length and can only be terminated through a specific remediation process or at the organization's request

The Health and Human Services Commission must adopt performance measures evaluating cost efficiency, quality of care, provider network quality, and member/provider satisfaction, incorporating CAHPS surveys and HEDIS measurement results, with monthly evaluations posted publicly on its website

Organizations with contract violations, bottom-quartile performance statewide, or lowest regional performance face escalating remedies: corrective action plans, damage recovery, suspension of default enrollment, and contract termination after 18 months without significant improvement

The commission must limit the number of managed care organizations operating in each Medicaid program per region and may restrict how many regions a single organization can serve

All pending STAR, CHIP, and STAR Kids procurements as of January 1, 2025 must be cancelled, with contracts awarded to organizations that held contracts on that date; STAR+Plus organizations with contracts as of January 1, 2029 will receive new contracts by January 1, 2030