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TX HB5184
Bill
Status
3/14/2025
Primary Sponsor
James Frank
Click for details
AI Summary
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Creates the Managed Care Consumer Choice Program, allowing the Health and Human Services Commission to periodically issue requests for applications from managed care organizations to provide health care services to Medicaid and CHIP recipients
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Requires managed care organizations to be certified, demonstrate financial solvency, and meet performance measures before receiving contracts; the commission must offer contracts to any qualifying organization that applies
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Applies to STAR, CHIP, STAR Kids, and STAR+PLUS programs but excludes STAR Health; recipients may select any contracted managed care plan in good standing within their service delivery area
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Establishes performance measures based on cost efficiency, quality of care, member and provider satisfaction, and provider network quality, with annual evaluations published on the commission's website
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Mandates implementation timeline: applications begin by September 1, 2026; STAR and CHIP services under new contracts by September 1, 2027; STAR Kids and STAR+PLUS by September 1, 2030; pending procurements as of January 1, 2025 must be cancelled
Legislative Description
Relating to the Managed Care Consumer Choice Program.
Health
Last Action
Referred to Human Services
4/7/2025