Sec. 531.06021. MEDICALLY DEPENDENT CHILDREN (MDCP) WAIVER PROGRAM QUALITY MONITORING; REPORT. (a) The commission, based on the state's external quality review organization's initial report on the STAR Kids managed care program, shall determine whether the findings of the report necessitate additional data and research to improve the program. If the commission determines additional data and research are needed, the commission, through the external quality review organization, may:
(1) conduct annual surveys of Medicaid recipients receiving benefits under the medically dependent children (MDCP) waiver program, or their representatives, using the Consumer Assessment of Healthcare Providers and Systems;
(2) conduct annual focus groups with recipients described by Subdivision (1) or their representatives on issues identified through:
(A) the Consumer Assessment of Healthcare Providers and Systems;
(B) other external quality review organization activities; or
(C) stakeholders, including the STAR Kids Managed Care Advisory Committee described by Section 533.00254; and
(3) in consultation with the STAR Kids Managed Care Advisory Committee described by Section 533.00254 and as frequently as feasible, calculate Medicaid managed care organizations' performance on performance measures using available data sources such as the collaborative innovation improvement network.
(b) Not later than the 30th day after the last day of each state fiscal quarter, the commission shall submit to the governor, the lieutenant governor, the speaker of the house of representatives, the Legislative Budget Board, and each standing legislative committee with primary jurisdiction over Medicaid a report containing, for the most recent state fiscal quarter, the following information and data related to access to care for Medicaid recipients receiving benefits under the medically dependent children (MDCP) waiver program:
(1) enrollment in the Medicaid buy-in for children program implemented under Section 531.02444;
(2) requests relating to interest list placements under Section 531.0601;
(3) use of the Medicaid escalation help line established under Section 533.00253, if the help line was operational during the applicable state fiscal quarter;
(4) use of, requests for, and outcomes of the external medical review procedure established under Section 531.024164; and
(5) complaints relating to the medically dependent children (MDCP) waiver program, categorized by disposition.
Added by Acts 2019, 86th Leg., R.S., Ch. 623 (S.B. 1207), Sec. 3(b), eff. September 1, 2019.