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A BILL TO BE ENTITLED
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AN ACT
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relating to the imposition of a late payment penalty against |
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Medicaid managed care organizations that fail to timely pay certain |
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physician and provider claims. |
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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 533.00551 to read as follows: |
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Sec. 533.00551. LATE PAYMENT PENALTY FOR CERTAIN CLAIMS. A |
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managed care organization that fails to pay a claim on or before the |
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15th day after the date the time limit for payment of the claim |
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prescribed by Section 533.005(a)(7) expires is liable to the |
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physician or provider who submitted the claim for a late payment |
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penalty. A late payment penalty under this section: |
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(1) is equal to 20 percent of the outstanding claim |
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amount; |
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(2) must be paid not later than the seventh day after |
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the date the liability for the penalty accrues under this section; |
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and |
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(3) is in addition to any other penalty or recourse to |
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which the physician or provider may be entitled under a contract |
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with the managed care organization. |
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SECTION 2. To the extent of a conflict between Section |
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533.00551, Government Code, as added by this Act, and a provision of |
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a contract between a managed care organization and a physician or |
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provider entered into before the implementation date of that |
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section, 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, 2017. |