Bill > HB5184

This bill establishes the Managed Care Consumer Choice Program, which changes how Texas manages its Medicaid and Children's Health Insurance Program (CHIP) contracts with managed care organizations. The bill requires the Health and Human Services Commission to periodically issue requests for applications from managed care organizations and establishes strict criteria for contract selection, including certification, financial solvency, and performance measures. The program will apply to STAR, CHIP, STAR Kids, and STAR + PLUS programs (but not STAR Health), and aims to give recipients more choice in selecting their managed care plans. The bill introduces detailed performance evaluation criteria that consider cost efficiency, quality of care, member and provider satisfaction, and provider network quality. Managed care organizations will be annually evaluated, with results posted publicly. The implementation will be phased, with new contracts for STAR and CHIP programs to begin by September 1, 2027, and STAR Kids and STAR + PLUS programs by September 1, 2030. Existing contracts will be extended until new contracts are in place, and recipients can continue with their current plan if the organization remains contracted. The bill provides flexibility for obtaining necessary federal waivers and will take effect either immediately with a two-thirds legislative vote or on September 1, 2025.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB5184