SRC-TJG C.S.H.B. 111 78(R)BILL ANALYSIS Senate Research CenterC.S.H.B. 111 By: Chavez (Zaffirini) Health & Human Services 5/19/2003 Committee Report (Substituted) 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. C.S.H.B. 111 holds health care providers, except for a physician, financially responsible if the ambulance service provider is denied payment because the health care provider did not receive prior authorization for the service. This bill also requires the Health and Human Services Commission to incorporate physician oriented instruction upon the appropriate procedures for authorizing ambulance service into current medical education courses. 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 nursing facility, health care provider, or other responsible party, other than a physician, that requested the service if certain conditions apply. Makes nonsubstantive changes. SECTION 2. Amends Section 32.024, Human Resources Code, by adding Subsection (z) to require the Health and Human Services Commission to incorporate physician-oriented instruction upon the appropriate procedures for authorizing ambulance service into current medical education courses. SECTION 3. Effective date: upon passage or September 1, 2003.