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A BILL TO BE ENTITLED
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AN ACT
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relating to reimbursement for certain emergency services provided |
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to persons enrolled in the Medicaid managed care program. |
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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 533.01316 to read as follows: |
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Sec. 533.01316. REIMBURSEMENT FOR CERTAIN EMERGENCY |
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SERVICES. (a) This section applies with respect to a recipient of |
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medical assistance who is an enrollee in a managed care plan under |
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any Medicaid managed care model or arrangement. |
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(b) The commission shall ensure that a person providing |
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ambulance services to a Medicaid managed care enrollee is |
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reimbursed for emergency services provided to the enrollee at a |
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rate that is equal to the allowable rate for those services as |
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determined under Section 32.028, Human Resources Code, regardless |
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of whether the services are provided by a provider in the applicable |
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Medicaid managed care plan's network of providers. |
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SECTION 2. 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 3. This Act takes effect September 1, 2011. |