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AN ACT
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relating to allowing Medicaid managed care organizations to engage |
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in marketing about the availability of certain private health |
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benefit plan coverage. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 540.0055, Government Code, as effective |
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April 1, 2025, is amended by adding Subsections (c) and (d) to read |
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as follows: |
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(c) The marketing guidelines the commission establishes |
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under this section may not prohibit a Medicaid managed care |
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organization from: |
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(1) informing an individual, including a current or |
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former recipient, about the availability of qualified health plans |
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offered through an exchange, as the terms "exchange" and "qualified |
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health plan" are defined by 45 C.F.R. Section 155.20; or |
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(2) advertising a Medicare Advantage plan or related |
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benefit offered under Part C of Title XVIII of the Social Security |
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Act (42 U.S.C. Section 1395w-21 et seq.) at a community enrollment |
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or other event. |
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(d) The marketing guidelines the commission establishes |
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under this section must require that a Medicaid managed care |
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organization that informs an individual about the availability of |
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qualified health plans offered through an exchange, as the terms |
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"exchange" and "qualified health plan" are defined by 45 C.F.R. |
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Section 155.20, also inform the individual about the potential |
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deductibles, copayments, and other cost-sharing requirements under |
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a qualified health plan. A Medicaid managed care organization |
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informing an individual about the availability of qualified health |
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plans offered through the exchange or an affiliate of the |
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organization may not offer the individual material or financial |
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gain as an actual or implied incentive for enrolling in a qualified |
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health plan. |
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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, 2025. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 963 passed the Senate on |
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April 10, 2025, by the following vote: Yeas 30, Nays 0; and that |
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the Senate concurred in House amendment on May 21, 2025, by the |
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following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 963 passed the House, with |
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amendment, on April 29, 2025, by the following vote: Yeas 119, |
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Nays 27, two present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |