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A BILL TO BE ENTITLED
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AN ACT
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relating to the reimbursement of certain durable medical equipment |
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providers participating in the Medicaid managed care program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 533.005, Government Code, is amended by |
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adding Subsection (i) to read as follows: |
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(i) In addition to the requirements specified by Subsection |
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(a) and notwithstanding any other law, a contract described by that |
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subsection must require the managed care organization to reimburse |
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a specialty provider of durable medical equipment and related |
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supplies and services who provides the equipment, supplies, or |
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services to a recipient at a rate that is at least equal to 95 |
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percent of the rate paid under the Medicaid fee-for-service fee |
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schedule. |
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SECTION 2. (a) The Health and Human Services Commission |
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shall, in a contract between the commission and a managed care |
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organization under Chapter 533, Government Code, that is entered |
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into or renewed on or after the effective date of this Act, require |
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that the managed care organization comply with Section 533.005(i), |
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Government Code, as added by this Act. |
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(b) The Health and Human Services Commission shall seek to |
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amend contracts entered into with managed care organizations under |
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Chapter 533, Government Code, before the effective date of this Act |
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to require those managed care organizations to comply with Section |
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533.005(i), Government Code, as added by this Act. To the extent of |
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a conflict between Section 533.005(i), Government Code, as added by |
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this Act, and a provision of a contract with a managed care |
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organization entered into before the effective date of this Act, |
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the contract provision prevails. |
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SECTION 3. 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 4. This Act takes effect September 1, 2023. |