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A BILL TO BE ENTITLED
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AN ACT
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relating to allowing health care providers to enter certain claims |
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and other information into the Medicaid electronic visit |
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verification system. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.024172(d), Government Code, is |
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amended to read as follows: |
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(d) In implementing the electronic visit verification |
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system: |
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(1) subject to Subsection (e), the executive |
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commissioner shall adopt compliance standards for health care |
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providers; and |
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(2) the commission shall ensure that: |
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(A) the information required to be reported by |
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health care providers is standardized across managed care |
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organizations that contract with the commission to provide health |
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care services to Medicaid recipients and across commission |
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programs; |
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(B) processes required by managed care |
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organizations to retrospectively correct data are standardized and |
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publicly accessible to health care providers; [and] |
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(C) standardized processes are established for |
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addressing the failure of a managed care organization to provide a |
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timely authorization for delivering services necessary to ensure |
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continuity of care; and |
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(D) a health care provider is allowed to: |
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(i) enter a variable schedule into the |
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electronic visit verification system; |
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(ii) complete electronic visit |
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verification system data maintenance within the 95-day period |
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following the date of a service delivery visit; and |
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(iii) submit a claim to be reimbursed for an |
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amount of time that: |
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(a) does not exceed the amount of |
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authorized hours unless the additional hours are approved by the |
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commission or the managed care organization; and |
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(b) is equal to or less than the |
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appropriately verified amount of time. |
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SECTION 2. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 3. This Act takes effect September 1, 2021. |