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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision of orthodontic services under the |
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Medicaid program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0271 to read as follows: |
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Sec. 32.0271. PROVIDERS OF ORTHODONTIC SERVICES. (a) |
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Orthodontic services designated as Level I or Level II by the |
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department under the medical assistance program, regardless of |
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whether under a fee-for-service or managed care model, must be |
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provided by a dentist licensed in this state who: |
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(1) has completed a residency in pediatric dentistry; |
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(2) has completed at least 200 hours of clinical |
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continuing dental education in orthodontics; or |
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(3) is board certified or eligible to become board |
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certified by a specialty orthodontic board recognized by the |
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American Dental Association. |
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(b) Orthodontic services designated as Level III or Level IV |
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by the department under the medical assistance program, regardless |
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of whether under a fee-for-service or managed care model, must be |
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provided by a dentist licensed in this state who is board certified |
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or eligible to become board certified by a specialty orthodontic |
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board recognized by the American Dental Association. |
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(c) The department may waive a requirement under this |
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section in rural areas with limited access to orthodontic care. |
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SECTION 2. (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 Section 32.0271, |
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Human Resources Code, as added 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 Section |
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32.0271, Human Resources Code, as added by this Act. To the extent |
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of a conflict between that section and a provision of a contract |
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with a managed care organization entered into before the effective |
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date of this Act, the contract provision prevails. |
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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, 2013. |