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R E S O L U T I O N
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BE IT RESOLVED by the House of Representatives of the State of |
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Texas, 86th Legislature, 2019, That House Rule 13, Section 9(a), be |
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suspended in part as provided by House Rule 13, Section 9(f), to |
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enable the conference committee appointed to resolve the |
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differences on Senate Bill 1207 (the operation and administration |
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of Medicaid, including the Medicaid managed care program and the |
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medically dependent children (MDCP) waiver program) to consider and |
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take action on the following matters: |
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(1) House Rule 13, Section 9(a)(4) is suspended to permit |
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the committee to add text on a matter not included in either the |
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house or senate version of the bill by adding the following SECTION |
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to the bill: |
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SECTION 2. Section 531.024, Government Code, is amended by |
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amending Subsection (b) and adding Subsection (c) to read as |
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follows: |
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(b) The rules promulgated under Subsection (a)(7) must |
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provide due process to an applicant for Medicaid services and to a |
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Medicaid recipient who seeks a Medicaid service, including a |
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service that requires prior authorization. The rules must provide |
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the protections for applicants and recipients required by 42 C.F.R. |
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Part 431, Subpart E, including requiring that: |
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(1) the written notice to an individual of the |
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individual's right to a hearing must: |
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(A) contain an explanation of the circumstances |
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under which Medicaid is continued if a hearing is requested; and |
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(B) be delivered by mail, and postmarked [mailed] |
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at least 10 business days, before the date the individual's |
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Medicaid eligibility or service is scheduled to be terminated, |
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suspended, or reduced, except as provided by 42 C.F.R. Section |
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431.213 or 431.214; and |
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(2) if a hearing is requested before the date a |
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Medicaid recipient's service, including a service that requires |
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prior authorization, is scheduled to be terminated, suspended, or |
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reduced, the agency may not take that proposed action before a |
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decision is rendered after the hearing unless: |
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(A) it is determined at the hearing that the sole |
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issue is one of federal or state law or policy; and |
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(B) the agency promptly informs the recipient in |
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writing that services are to be terminated, suspended, or reduced |
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pending the hearing decision. |
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(c) The commission shall develop a process to address a |
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situation in which: |
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(1) an individual does not receive adequate notice as |
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required by Subsection (b)(1); or |
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(2) the notice required by Subsection (b)(1) is |
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delivered without a postmark. |
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Explanation: This addition is necessary to change the |
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requirements for notice of a right to a hearing for an applicant for |
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Medicaid services and a Medicaid recipient. |
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(2) House Rule 13, Section 9(a)(4) is suspended to permit |
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the committee to add text on a matter not included in either the |
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house or senate version of the bill by adding the following text to |
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SECTION 3 of the bill: |
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(a) To the extent of any conflict, Section 531.024162, |
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Government Code, as added by this section, prevails over any |
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provision of another Act of the 86th Legislature, Regular Session, |
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2019, relating to notice requirements regarding Medicaid coverage |
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or prior authorization denials or incomplete requests, that becomes |
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law. |
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Explanation: This addition is necessary to provide that the |
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amendment adding Section 531.024162, Government Code, prevails |
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over other similar amendments made by the 86th Legislature. |
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Krause |
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______________________________ |
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Speaker of the House |
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I certify that H.R. No. 2189 was adopted by the House on May |
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26, 2019, by the following vote: Yeas 142, Nays 2, 1 present, not |
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voting. |
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______________________________ |
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Chief Clerk of the House |
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