By Maxey H.B. No. 867 74R2352 KLL-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to an automated system for providing reimbursements to 1-3 nursing homes under the state Medicaid program. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Chapter 242, Health and Safety Code, is amended 1-6 by adding Subchapter H to read as follows: 1-7 SUBCHAPTER H. AUTOMATED MEDICAID REIMBURSEMENT SYSTEM 1-8 Sec. 242.201. AUTOMATED SYSTEM FOR MEDICAID REIMBURSEMENT. 1-9 (a) The department shall acquire and develop an automated system 1-10 for providing reimbursements to nursing homes under the state 1-11 Medicaid program. 1-12 (b) The department shall select an automated system that 1-13 will allow the addition of other components of the state Medicaid 1-14 program, including components administered by other state agencies. 1-15 (c) The department and the Health and Human Services 1-16 Commission shall work together to apply for all available federal 1-17 funds to help pay for the automated system. 1-18 Sec. 242.202. DATA USED BY SYSTEM. The automated 1-19 reimbursement system must use the data on the MDS+ form designed by 1-20 the United States Health Care Financing Administration for nursing 1-21 home use. 1-22 Sec. 242.203. ELECTRONIC CLAIMS FOR REIMBURSEMENT. (a) The 1-23 automated reimbursement system must be able to link the department 1-24 electronically with nursing homes making claims for reimbursement. 2-1 When the system is operational, each nursing home shall make claims 2-2 electronically. 2-3 (b) The department shall charge a fee to nursing homes that 2-4 do not make their claims for reimbursement electronically. The 2-5 department shall set the fee in an amount necessary to cover the 2-6 costs of manually processing the claims. 2-7 Sec. 242.204. DATE OF REIMBURSEMENT. The department shall 2-8 pay nursing home reimbursement claims under the state Medicaid 2-9 program that are made electronically not later than the 30th day 2-10 after the date the claim is made. 2-11 Sec. 242.205. RULES. The department shall adopt rules and 2-12 make policy changes as necessary to improve the efficiency of the 2-13 reimbursement process and to maximize the automated reimbursement 2-14 system's capabilities. 2-15 SECTION 2. (a) The Texas Department of Human Services shall 2-16 implement the nursing home reimbursement component of the automated 2-17 reimbursement system required under Subchapter H, Chapter 242, 2-18 Health and Safety Code, as added by this Act, not later than 2-19 September 1, 1996. The Health and Human Services Commission shall 2-20 evaluate and determine deadlines for using the system for other 2-21 components of the state Medicaid program and shall work with health 2-22 and human services agencies to allocate costs. 2-23 (b) The department shall give priority to developing and 2-24 implementing the automated reimbursement system under this section 2-25 over any other equipment and automation upgrades. 2-26 (c) The department shall reduce staff and purchases as 2-27 savings and efficiency from implementing the automated 3-1 reimbursement system are realized. 3-2 SECTION 3. The importance of this legislation and the 3-3 crowded condition of the calendars in both houses create an 3-4 emergency and an imperative public necessity that the 3-5 constitutional rule requiring bills to be read on three several 3-6 days in each house be suspended, and this rule is hereby suspended, 3-7 and that this Act take effect and be in force from and after its 3-8 passage, and it is so enacted.