TX HB5185

Managed care organization contracts under Medicaid (STAR, STAR Kids, STAR+Plus) and the child health plan program will have no set term length and can only be terminated through a specific remediation process or at the organization's request

The commission must adopt and publish performance measures evaluating cost efficiency, quality of care, member/provider satisfaction, provider network quality, and past experience, with required monthly evaluations posted publicly on the commission's website

Organizations performing in the bottom quartile statewide or lowest in their region face escalating remedies: corrective action plans, damages recovery, suspension of default enrollment, and contract termination if no significant improvement occurs within 18 months

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

Competitive procurement for new managed care contracts occurs only when an existing contract is terminated, with preference given to organizations with strong participation from traditional Medicaid/charity care providers and those offering continuity of care beyond eligibility periods