S.B. No. 79
AN ACT
1-1 relating to the state system of selective contracting with health
1-2 care providers for the provision of certain services to Medicaid
1-3 recipients and certain requirements for those providers.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subsection (a), Section 32.027, Human Resources
1-6 Code, is amended to read as follows:
1-7 (a) Except as provided by Subsections (f), (g), and (h), a
1-8 <A> recipient of medical assistance authorized in this chapter may
1-9 select any provider authorized by the department to provide medical
1-10 assistance.
1-11 SECTION 2. Section 32.027, Human Resources Code, is amended
1-12 by adding Subsections (f), (g), and (h) to read as follows:
1-13 (f) The department by rule shall develop a system of
1-14 selective contracting with health care providers for the provision
1-15 of nonemergency inpatient hospital services to a recipient of
1-16 medical assistance under this chapter. In implementing this
1-17 subsection, the department shall:
1-18 (1) seek input from consumer representatives and from
1-19 representatives of hospitals licensed under Chapter 241, Health and
1-20 Safety Code, and from organizations representing those hospitals;
1-21 and
1-22 (2) ensure that providers selected under the system
1-23 meet the needs of a recipient of medical assistance under this
1-24 chapter.
2-1 (g) The process to select a hospital must afford each
2-2 disproportionate share hospital an opportunity to negotiate for a
2-3 contract. The process will take into account the special
2-4 circumstances of disproportionate share hospitals when evaluating
2-5 proposals.
2-6 (h) A proposal or bid submitted by a hospital and any work
2-7 papers, cost reports, or other financial data used to prepare the
2-8 proposal or bid shall be confidential and not subject to required
2-9 disclosure by the department or the hospital under any other
2-10 statute until the executed contracts have been awarded.
2-11 SECTION 3. Section 32.029, Human Resources Code, is amended
2-12 by adding Subsection (e) to read as follows:
2-13 (e) The department or its designee must notify providers of
2-14 health care services in clear and concise language of the status of
2-15 their claims on any claim not paid or denied within 30 days of
2-16 receipt by the payor.
2-17 SECTION 4. If before implementing Subsection (f) or (g),
2-18 Section 32.027, Human Resources Code, as added by this Act, the
2-19 Health and Human Services Commission determines that a waiver or
2-20 authorization from a federal agency is necessary for
2-21 implementation, the commission shall request the waiver or
2-22 authorization and may authorize a delay in implementing that
2-23 provision until the waiver or authorization is granted.
2-24 SECTION 5. The Health and Human Services Commission and the
2-25 Texas Department of Health may contract with other state agencies
2-26 to implement Title XIX of the Social Security Act (42 U.S.C.
2-27 Section 1396 et seq.) to the same extent as granted to the Texas
3-1 Department of Human Services under Section 32.023, Human Resources
3-2 Code.
3-3 SECTION 6. This Act takes effect September 1, 1993.
3-4 SECTION 7. The importance of this legislation and the
3-5 crowded condition of the calendars in both houses create an
3-6 emergency and an imperative public necessity that the
3-7 constitutional rule requiring bills to be read on three several
3-8 days in each house be suspended, and this rule is hereby suspended.