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A BILL TO BE ENTITLED
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AN ACT
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relating to reimbursement through the Medicaid program of |
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nonemergency services provided through hospital emergency rooms. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 32.0641(a), Human Resources Code, is |
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amended to read as follows: |
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(a) To the extent permitted under and in a manner that is |
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consistent with Title XIX, Social Security Act (42 U.S.C. Section |
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1396 et seq.) and any other applicable law or regulation or under a |
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federal waiver or other authorization, the executive commissioner |
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of the Health and Human Services Commission shall adopt, after |
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consulting with the Medicaid and CHIP Quality-Based Payment |
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Advisory Committee established under Section 536.002, Government |
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Code, cost-sharing provisions that encourage personal |
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accountability and appropriate utilization of health care |
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services[, including a cost-sharing provision applicable to a
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recipient who chooses to receive a nonemergency medical service
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through a hospital emergency room]. |
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SECTION 2. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0643 to read as follows: |
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Sec. 32.0643. REIMBURSEMENT FOR NONEMERGENCY SERVICES IN |
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EMERGENCY ROOMS PROHIBITED. (a) To the extent permitted under and |
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in a manner that is consistent with Title XIX, Social Security Act |
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(42 U.S.C. Section 1396 et seq.), and any other federal law, and |
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notwithstanding any other law, the executive commissioner of the |
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Health and Human Services Commission shall adopt rules to ensure |
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that the department does not provide reimbursement through the |
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Medicaid program for a nonemergency medical service provided |
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through a hospital emergency room. |
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(b) Notwithstanding Subsection (a), the department shall |
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provide reimbursement through the Medicaid program for an |
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appropriate emergency medical screening examination to the extent |
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reimbursement is required under Section 1867, Social Security Act |
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(42 U.S.C. Section 1395dd). |
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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. |