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A BILL TO BE ENTITLED
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AN ACT
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relating to the billing coordination system for claims submitted |
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for payment from the Medicaid program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.02413, Government Code, as added by |
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Chapter 268 (S.B. 10), Acts of the 80th Legislature, Regular |
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Session, 2007, is amended by adding Subsection (a-1) and amending |
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Subsections (b) and (c) to read as follows: |
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(a-1) If cost-effective and feasible, the commission shall |
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contract to expand the Medicaid billing coordination system |
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described by Subsection (a) to process claims for all other health |
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care services provided through the Medicaid program in the manner |
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claims for acute care services are processed by the system under |
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Subsection (a). This subsection does not apply to claims for health |
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care services provided through the Medicaid program if, before |
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September 1, 2009, those claims were being processed by an |
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alternative billing coordination system. |
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(b) If cost-effective, the executive commissioner shall |
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adopt rules for the purpose of enabling the system described by |
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Subsection (a) to identify an entity with primary responsibility |
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for paying a claim that is processed by the system under Subsection |
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(a) and establish reporting requirements for any entity that may |
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have a contractual responsibility to pay for the types of [acute
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care] services that are provided under the Medicaid program and the |
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claims for which are processed by the system under Subsection (a). |
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(c) An entity that holds a permit, license, or certificate |
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of authority issued by a regulatory agency of the state must allow a |
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[the] contractor under this section [Subsection (a)] access to |
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databases to allow the contractor to carry out the purposes of this |
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section, subject to the contractor's contract with the commission |
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and rules adopted under this section, and is subject to an |
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administrative penalty or other sanction as provided by the law |
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applicable to the permit, license, or certificate of authority for |
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a violation by the entity of a rule adopted under this section. |
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SECTION 2. The Health and Human Services Commission may |
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seek to amend an existing contract entered into under Section |
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531.02413, Government Code, as added by Chapter 268 (S.B. 10), Acts |
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of the 80th Legislature, Regular Session, 2007, or may enter into a |
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new contract, to implement the changes made to that section by this |
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Act. |
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SECTION 3. 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 4. This Act takes effect September 1, 2009. |