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A BILL TO BE ENTITLED
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AN ACT
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relating to the reimbursement rate for the provision of vagus nerve |
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stimulation therapy system devices by certain health care providers |
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under Medicaid. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.03145 to read as follows: |
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Sec. 32.03145. REIMBURSEMENT FOR VAGUS NERVE STIMULATION |
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THERAPY SYSTEM DEVICE PROVIDED BY CERTAIN PROVIDERS. (a) This |
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section applies only to the following providers under the medical |
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assistance program: |
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(1) a hospital licensed under Chapter 241, Health and |
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Safety Code, that provides acute care services; or |
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(2) an ambulatory surgical center licensed under |
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Chapter 243, Health and Safety Code. |
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(b) The executive commissioner shall ensure that the rules |
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governing the determination of reimbursement rates paid to a |
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provider subject to this section for the provision of a vagus nerve |
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stimulation therapy system device to a medical assistance recipient |
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is: |
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(1) at least equal to 82 percent of the device's |
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acquisition cost; and |
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(2) in addition to any other surgery fee charged by the |
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provider. |
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SECTION 2. 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), a contract described by that subsection must contain a |
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requirement that a managed care organization comply with Section |
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32.03145, Human Resources Code. |
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SECTION 3. (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 4. 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 5. This Act takes effect September 1, 2023. |