SRC-TJG H.B. 111 78(R)   BILL ANALYSIS


Senate Research Center   H.B. 111
78R355 SGA-DBy: Chavez (Zaffirini)
Health & Human Services
5/10/2003
Engrossed


DIGEST AND PURPOSE 

Medicaid health care providers are required under the Medicaid program to
provide and arrange non-emergency transportation for their severely
disabled Medicaid patients.  This requirement includes obtaining prior
authorization from the Health and Human Services Commission before
contacting the ambulance provider for transportation.  Currently, the
medical assistance program can deny payment to the ambulance service
provider if prior authorization is not received by the health care
provider.  H.B. 111 holds health care providers financially responsible if
the ambulance service provider is denied payment because the health care
provider did not receive prior authorization for the service. 

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to
a state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 32.024(t), Human Resources Code, to add that
the rules adopted under this section are required to provide that a person
denied payment for ambulance services rendered is entitled to payment from
the physician, nursing facility, health care provider, or other
responsible party that requested the service if certain conditions apply.
Makes nonsubstantive changes. 

SECTION 2.  Effective date: upon passage or September 1, 2003.