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A BILL TO BE ENTITLED
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AN ACT
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relating to a three-party integrated model of care for certain |
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Medicaid recipients. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 533, Government Code, is |
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amended by adding Section 533.0073 to read as follows: |
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Sec. 533.0073. THREE-PARTY INTEGRATED MODEL OF |
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CARE. (a) The commission may, if cost-effective and feasible, |
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develop and implement a three-party integrated model of care to |
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fully integrate services under the state Medicaid program with |
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services under the Medicare program for individuals dually eligible |
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for Medicare and Medicaid. The three parties participating in the |
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model of care are the commission, the Centers for Medicare and |
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Medicaid Services, and a managed care organization. |
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(b) The three-party integrated model of care must be |
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designed to: |
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(1) improve the quality, coordination, and |
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cost-effectiveness of services and the management of care for |
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persons described by Subsection (a); and |
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(2) integrate the financing of those services. |
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(c) The commission may implement the three-party integrated |
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model of care in areas of the state with existing Medicaid managed |
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care programs, including a Medicaid Star+Plus pilot program, |
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through and in a manner that is coordinated with the existing |
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program. |
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(d) The executive commissioner of the Health and Human |
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Services Commission shall: |
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(1) seek approval for any waivers necessary to |
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implement a three-party integrated model of care; and |
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(2) adopt rules prescribing eligibility requirements |
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to participate in the model of care, program benefits, and provider |
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requirements. |
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SECTION 2. This Act takes effect September 1, 2007. |