| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to reimbursement for certain emergency eye health care |
|
|
services provided to persons enrolled in the Medicaid managed care |
|
|
program. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subchapter A, Chapter 533, Government Code, is |
|
|
amended by adding Section 533.00265 to read as follows: |
|
|
Sec. 533.00265. EMERGENCY EYE HEALTH CARE SERVICES. A |
|
|
managed care organization that contracts with the commission under |
|
|
this chapter shall reimburse an out-of-network eye care specialist |
|
|
who is an enrolled Medicaid provider for providing to a recipient |
|
|
enrolled in the organization's managed care plan emergency eye |
|
|
health care services, including services to treat an emergency |
|
|
medical condition affecting the visual system, eye, or adnexa, as |
|
|
determined by executive commissioner rule, at a rate equal to the |
|
|
rate at which the managed care organization would reimburse an eye |
|
|
care specialist in the organization's provider network for the same |
|
|
services. |
|
|
SECTION 2. As soon as practicable after the effective date |
|
|
of this Act, the executive commissioner of the Health and Human |
|
|
Services Commission shall adopt the rules required by Section |
|
|
533.00265, Government Code, as added by this Act. |
|
|
SECTION 3. If before implementing any provision of this Act |
|
|
a state agency determines that a waiver or authorization from a |
|
|
federal agency is necessary for implementation of that provision, |
|
|
the agency affected by the provision shall request the waiver or |
|
|
authorization and may delay implementing that provision until the |
|
|
waiver or authorization is granted. |
|
|
SECTION 4. This Act takes effect immediately if it receives |
|
|
a vote of two-thirds of all the members elected to each house, as |
|
|
provided by Section 39, Article III, Texas Constitution. If this |
|
|
Act does not receive the vote necessary for immediate effect, this |
|
|
Act takes effect September 1, 2015. |