By Ellis                                              S.B. No. 1392
       74R8011 CAG-F
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the participation in certain governmental health care
    1-3  programs by a licensed health care professional.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,
    1-6  is amended by adding Section 32.043 to read as follows:
    1-7        Sec. 32.043.  IMPROVING ACCOUNTABILITY AND ACCESS.  (a)  The
    1-8  department by rule shall adopt a reporting system that requires a
    1-9  claimant seeking Medicaid reimbursement for a service  to indicate
   1-10  the type of license and the identification number of the licensed
   1-11  health care provider who provided the service.
   1-12        (b)  A provider who receives reimbursement from state funds,
   1-13  including a payment from a third party health insurance company if
   1-14  the premiums for the health insurance are paid in part with state
   1-15  funds, may not refuse:
   1-16              (1)  service to a person who has Medicaid coverage
   1-17  unless 12.5 percent or more of the provider's patient contacts are
   1-18  contacts with persons who have Medicaid coverage; or
   1-19              (2)  a referral of a person who has Medicaid coverage
   1-20  made by an advanced nurse practitioner.
   1-21        SECTION 2.  Subtitle C, Title 2, Human Resources Code, is
   1-22  amended by adding Chapter 36 to read as follows:
   1-23            CHAPTER 36.  PROVIDER PARTICIPATION IN CERTAIN
   1-24                         HEALTH CARE PROGRAMS
    2-1        Sec. 36.001.  DISCRIMINATION AGAINST CERTAIN PROVIDERS.  A
    2-2  state administered or other statutorily mandated health care
    2-3  program may not refuse the participation in the health care program
    2-4  by a licensed health care provider who provides a service provided
    2-5  by the program if the provision of the service is within the scope
    2-6  of the provider's license.
    2-7        Sec. 36.002.  RATE OF REIMBURSEMENT.  The rate of
    2-8  reimbursement for a service provided by a licensed health care
    2-9  provider under a state administered or another statutorily mandated
   2-10  health care program shall be determined by the agency administering
   2-11  the health care program after the agency has reviewed comments made
   2-12  by a committee appointed by the agency that consists of an equal
   2-13  number of consumers and licensed health care providers who receive
   2-14  reimbursement from the program.
   2-15        SECTION 3.  This Act takes effect September 1, 1995.
   2-16        SECTION 4.  The importance of this legislation and the
   2-17  crowded condition of the calendars in both houses create an
   2-18  emergency and an imperative public necessity that the
   2-19  constitutional rule requiring bills to be read on three several
   2-20  days in each house be suspended, and this rule is hereby suspended.