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A BILL TO BE ENTITLED
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AN ACT
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relating to reimbursement for ambulance services provided to |
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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 AMBULANCE SERVICES. (a) |
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This section applies with respect to a recipient of medical |
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assistance who is an enrollee in a managed care plan under any |
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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 and nonemergency services provided to the |
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enrollee at a rate that is equal to 100 percent of the allowable |
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rate for those services as determined under Section 32.028, Human |
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Resources Code, regardless of whether the services are provided by |
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a provider in the applicable Medicaid managed care plan's network |
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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, 2015. |