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Bill

HB 5183

Relating to contracts with managed care organizations, including the procurement of managed care contracts, under Medicaid and the child health plan program.

89th Legislature (2025) Introduced by James Frank

HB 5183 restructures Texas Medicaid and CHIP managed care procurement and contract standards, affecting healthcare delivery for 4+ million low-income beneficiaries.

Referred to Human Services
#health&humanservicescommission(v0177) #health--children'sinsurance(i0388) #humanservices--childservices(i0895) #humanservices--medicalassistance(i0905) #managedcare(s0454) #medicaid(s4885)
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Bill Summary · HB 5183

Legislative bill overview

HB 5183 modifies Texas procurement procedures and contract requirements for managed care organizations (MCOs) that provide services through Medicaid and the Child Health Plan Program (CHIP). The bill establishes new standards for how the state contracts with these insurance companies and potentially alters oversight mechanisms for managed care delivery.

Why is this important

Medicaid and CHIP serve approximately 4+ million low-income Texans, with managed care organizations controlling the delivery and costs of healthcare for the majority of these beneficiaries. Changes to MCO procurement and contract terms directly affect healthcare access, quality, and costs for vulnerable populations including children, elderly, and disabled individuals, while also impacting state budget allocations.

Potential points of contention

  • Procurement transparency and competition: Changes to procurement processes could either strengthen competitive bidding among MCOs or potentially reduce the number of bidders depending on implementation, affecting service quality and cost control
  • Beneficiary protections vs. operational flexibility: Tighter contract requirements may improve accountability but could increase administrative costs that MCOs pass to the state, or conversely, looser requirements may reduce costs but compromise care standards
  • Regional access concerns: New contracting terms might affect MCO participation in rural or underserved areas, potentially limiting beneficiary choice in less profitable regions

Compiled from official sources — confirm details with the bill’s official record.

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