By Gray H.B. No. 2236
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to contracts for Medicaid managed care.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 533.004, Government Code, is amended by
1-5 amending Subsection (a) and adding Subsection (e) to read as
1-6 follows:
1-7 (a) In providing health care services through Medicaid
1-8 managed care to recipients in a health care service region, the
1-9 commission shall contract with a [at least one] managed care
1-10 organization in that region that is licensed under the Texas Health
1-11 Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
1-12 Code) to provide health care in that region and that is:
1-13 (1) wholly owned and operated by a hospital district
1-14 in that region;
1-15 (2) created by a nonprofit corporation that:
1-16 (A) has a contract, agreement, or other
1-17 arrangement with a hospital district in that region or with a
1-18 municipality in that region that owns a hospital licensed under
1-19 Chapter 241, Health and Safety Code, and has an obligation to
1-20 provide health care to indigent patients; and
1-21 (B) under the contract, agreement, or other
1-22 arrangement, assumes the obligation to provide health care to
1-23 indigent patients and leases, manages, or operates a hospital
1-24 facility owned by the hospital district or municipality; or
2-1 (3) created by a nonprofit corporation that has a
2-2 contract, agreement, or other arrangement with a hospital district
2-3 in that region under which the nonprofit corporation acts as an
2-4 agent of the district and assumes the district's obligation to
2-5 arrange for services under the Medicaid expansion for children as
2-6 authorized by Chapter 444, Acts of the 74th Legislature, Regular
2-7 Session, 1995.
2-8 (e) In providing health care services through Medicaid
2-9 managed care to recipients in a health care service region, with
2-10 the exception of the Harris service area for the STAR Medicaid
2-11 managed care program, as defined by the commission as of the
2-12 initial implementation date for that service area, the commission
2-13 shall also contract with a managed care organization in that region
2-14 that holds a certificate of authority as a health maintenance
2-15 organization under Section 5, Texas Health Maintenance Organization
2-16 Act (Article 20A.05, Vernon's Texas Insurance Code), and that:
2-17 (1) is certified under Section 5.01(a), Medical
2-18 Practice Act (Article 4495b, Vernon's Texas Civil Statutes);
2-19 (2) is created by The University of Texas Medical
2-20 Branch at Galveston; and
2-21 (3) has obtained a certificate of authority as a
2-22 health maintenance organization to serve one or more counties in
2-23 that region from the Texas Department of Insurance before September
2-24 2, 1999.
2-25 SECTION 2. The importance of this legislation and the
2-26 crowded condition of the calendars in both houses create an
2-27 emergency and an imperative public necessity that the
3-1 constitutional rule requiring bills to be read on three several
3-2 days in each house be suspended, and this rule is hereby suspended,
3-3 and that this Act take effect and be in force from and after its
3-4 passage, and it is so enacted.