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A BILL TO BE ENTITLED
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AN ACT
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relating to offering certain evidence-based services in lieu of |
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other mental health or substance use disorder services by a |
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Medicaid managed care organization. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 533.005, Government Code, is amended by |
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adding Subsection (g) to read as follows: |
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(g) In addition to the requirements specified by Subsection |
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(a), a contract described by that subsection must contain language |
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permitting a managed care organization to offer medically |
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appropriate, cost-effective, evidence-based services from a list |
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approved by the state Medicaid managed care advisory committee and |
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included in the contract in lieu of mental health or substance use |
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disorder services specified in the state Medicaid plan. A |
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recipient is not required to use a service from the list included in |
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the contract in lieu of another mental health or substance use |
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disorder service specified in the state Medicaid plan. The |
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commission shall: |
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(1) prepare and submit an annual report to the |
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legislature on the number of times during the preceding year a |
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service from the list included in the contract is used; and |
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(2) take into consideration the actual cost and use of |
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any services from the list included in the contract that are offered |
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by a managed care organization when setting the capitation rates |
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for that organization under the contract. |
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SECTION 2. Section 533.005, Government Code, as amended by |
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this Act, applies to a contract entered into or renewed on or after |
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the effective date of this Act. A contract entered into or renewed |
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before that date is governed by the law in effect on the date the |
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contract was entered into or renewed, and that law is continued in |
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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 September 1, 2019. |