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A BILL TO BE ENTITLED
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AN ACT
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relating to reimbursement for medical assistance provided by a |
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school-based health center to certain recipients. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 32.028, Human Resources Code, is amended |
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by adding Subsections (o) and (p) to read as follows: |
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(o) Notwithstanding any other law, the executive |
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commissioner of the Health and Human Services Commission by rule |
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shall ensure that a school-based health center established under |
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Subchapter B, Chapter 38, Education Code, is reimbursed under the |
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medical assistance program for the provision to a recipient of |
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medical assistance of a medical assistance service or procedure, |
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regardless of whether the recipient: |
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(1) is required to have a primary care physician or |
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other gatekeeper or health care coordinator; or |
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(2) has obtained a referral for the service or |
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procedure from that physician, gatekeeper, or coordinator that is |
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otherwise required. |
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(p) Subsection (o) may not be construed to expand the scope |
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of services and procedures provided under the medical assistance |
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program. |
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SECTION 2. Except as provided by Section 3(b) of this Act, |
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Section 32.028(o), Human Resources Code, as added by this Act, |
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applies to a reimbursement for a medical assistance health care |
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service or procedure that is provided on or after the effective date |
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of this Act by a school-based health center. |
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SECTION 3. (a) The Health and Human Services Commission |
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shall, in a contract between the commission and a managed care |
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organization under Chapter 533, Government Code, that is entered |
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into or renewed on or after the effective date of this Act, require |
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that the managed care organization comply with rules adopted in |
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accordance with Section 32.028(o), Human Resources Code, as added |
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by this Act. |
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(b) The Health and Human Services Commission shall seek to |
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amend contracts entered into with managed care organizations under |
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Chapter 533, Government Code, before the effective date of this Act |
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to require those managed care organizations to comply with rules |
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adopted in accordance with Section 32.028(o), Human Resources Code, |
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as added by this Act. To the extent of a conflict between that |
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section and a provision of a contract with a managed care |
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organization entered into before the effective date of this Act, |
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the contract provision prevails. |
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SECTION 4. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 5. This Act takes effect September 1, 2009. |