By Zaffirini, et al. S.B. No. 1164 75R5905 SAW-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to Medicaid managed care contract compliance. 1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-4 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, 1-5 is amended by adding Section 32.043 to read as follows: 1-6 Sec. 32.043. MANAGED CARE CONTRACT COMPLIANCE. (a) The 1-7 department shall review each managed care organization that has 1-8 contracted with the department to provide medical assistance to 1-9 medical assistance recipients through a managed care plan issued by 1-10 the organization to determine whether the organization is prepared 1-11 to meet its contractual obligations. 1-12 (b) The department shall conduct the review not later than 1-13 the 60th day before the date on which medical assistance recipients 1-14 may begin enrolling in the organization's managed care plan. 1-15 (c) The review shall include an on-site inspection and tests 1-16 of service authorization and claims payment systems, complaint 1-17 processing systems, and any other process or system required by the 1-18 contract. 1-19 (d) The department may delay enrollment of medical 1-20 assistance recipients in a managed care plan if the review reveals 1-21 that the managed care organization is not prepared to meet its 1-22 contractual obligations. 1-23 (e) The department shall identify and review the 1-24 administrative costs of each managed care organization that 2-1 contracts with the department. The department by rule may limit 2-2 these administrative costs. 2-3 SECTION 2. This Act takes effect September 1, 1997, and 2-4 applies only to a contract with a managed care organization that 2-5 the department enters into or renews on or after that date. A 2-6 contract with a managed care organization that the department 2-7 enters into or renews before September 1, 1997, is governed by the 2-8 law as it existed immediately before that date, and that law is 2-9 continued in effect for that purpose. 2-10 SECTION 3. The importance of this legislation and the 2-11 crowded condition of the calendars in both houses create an 2-12 emergency and an imperative public necessity that the 2-13 constitutional rule requiring bills to be read on three several 2-14 days in each house be suspended, and this rule is hereby suspended.