NDG’s View
Texas Rep. Toni Rose (D-110) filed a bill (HB 3549) on March 6 which, if passed, would have allowed hospitals to keep patients longer than the current guidelines allow under the “Star-Plus” Medicaid program. Currently, there is a 30-day “spell of illness” limitation, after which a patient must be outside a treatment facility for 60 consecutive days before receiving inpatient treatment again.
The goal of Rose’s bill was to remove that limitation, allowing healthcare facilities to keep patients in the hospital longer.
The Star-Plus Medicaid program, administered in Texas by the Department of Health and Human Services, is geared toward persons over 21 years of age in assisted living centers, low income, or other conditions on a short list of acceptance requirements. Treatment for Star-Plus patients is offered through a wide range of healthcare programs statewide.
HB 3549 would have required any such provider to remove the 30 days of illness restriction for any provider receiving funds for treatment through the Star-Plus program.
However, expanding medical services does not come without a cost, and a financial impact statement authored by John McGeady and Sarah Keyton, both assistant directors of the Legislative Budget Board, outlined the potential expense of such a change in policy.
“HHSC estimates the costs to remove the spell of illness limitation under Star+Plus to be $110.8 million in All Funds, including $67.2 million in General Revenue Funds, in fiscal year 2020 increasing to $145.7 million in All Funds, including $88.0 million in General Revenue Funds, by the fiscal year 2024 for increased Medicaid client services costs including costs related to the Health Insurance Providers Fee based on current Star+Plus enrollment and cost trends,” the report read.
“Client services costs are assumed to result in an increase in insurance premium tax revenue, estimated to be 1.75 percent of the increased managed care expenditures. Revenue is adjusted for assumed timing of payments and prepayments resulting in an estimated increase of $1.3 million in the fiscal year 2020, $3.4 million in the fiscal year 2021, and between $2.2 million and $2.5 million in each fiscal until the fiscal year 2024.”
The report also noted a one-time expense in modifying the systems to adapt to such changes would amount to an extra $400,000 in the fiscal year 2020.
However, this expense to the taxpayer would mean more revenue for the provider of healthcare services with more extended stays in facilities … a lot more income. Of note, the healthcare industry was the third highest contributor of funds to Rose’s campaign, according to Votesmart.org, with $23,500 in donations. Donations included funds from organizations like the Texas Hospital Association and Border Health PAC, known for working to influence lawmakers. The latter of which was noted by TransparencyTexas.org for a “lavish gift” of $75,000 to “notoriously conservative” Texas Attorney General Ken Paxton.
The real goal and impact of the bill may never be known. Like many bills, HB 3549 seems to have “died in committee.” NDG reached to Rep. Rose’s office but did not receive a response.
After being filed on March 6, the bill was read for the first time and referred to the Human Services committee on March 18. Once in committee, HB 3549 was scheduled for hearing on April 23, after which the committee took no action on the bill. There have been no amendments offered, and no indication the bill will move forward by the time the current legislative session ends.
 filed a bill (HB 3549) on March 6 which, if passed, would have allowed hospitals to keep patients longer than the current guidelines allow under the “Star-Plus” Medicaid program. Currently, there is a 30-day “spell of illness” limitation, after which a patient must be outside a treatment facility for 60 consecutive days before receiving inpatient treatment again.){kind=link}