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A BILL TO BE ENTITLED
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AN ACT
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relating to contracts with managed care organizations under the |
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Medicaid managed care delivery model. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 533.004(a), Government Code, is amended |
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to read as follows: |
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(a) In providing health care services through Medicaid |
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managed care to recipients in a health care service region, the |
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commission shall contract with a managed care organization in that |
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region that is licensed under Chapter 843, Insurance Code, to |
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provide health care in that region and that is: |
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(1) wholly owned and operated by a hospital district |
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in that region; |
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(2) created or owned by a nonprofit corporation that: |
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(A) has a contract, agreement, or other |
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arrangement with: |
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(i) a hospital district; |
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(ii) a municipal hospital authority in that |
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region created under Chapter 262, Health and Safety Code, that is |
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located in a county with a population of at least 25,000 and not |
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more than 40,000 that is adjacent to a county with a population of |
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at least 85,000 and not more than 110,000; or |
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(iii) [with] a municipality in that region |
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that owns a hospital licensed under Chapter 241, Health and Safety |
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Code, and has an obligation to provide health care to indigent |
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patients; and |
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(B) under the contract, agreement, or other |
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arrangement: |
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(i) [,] assumes the obligation, if |
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applicable, to provide health care to indigent patients; and |
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(ii) leases, manages, or operates a hospital |
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facility owned by the hospital district, hospital authority, or |
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municipality; or |
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(3) created by a nonprofit corporation that has a |
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contract, agreement, or other arrangement with a hospital district |
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in that region under which the nonprofit corporation acts as an |
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agent of the district and assumes the district's obligation to |
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arrange for services under the Medicaid expansion for children as |
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authorized by Chapter 444, Acts of the 74th Legislature, Regular |
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Session, 1995. |
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SECTION 2. The change in law made by this Act applies only |
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to a contract entered into or renewed on or after the effective date |
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of this Act. A contract entered into or renewed before the |
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effective date of this Act is governed by the law in effect |
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immediately before the effective date of this Act, and that law is |
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continued in effect for that purpose. |
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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 immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2013. |