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A BILL TO BE ENTITLED
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AN ACT
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relating to the award of health plan provider contracts under the |
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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. Section 533.004(a), Government Code, is amended |
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to read as follows: |
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(a) In providing health care services through Medicaid |
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managed care to recipients in a health care service region, the |
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commission shall contract with a managed care organization in that |
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region that is licensed under Chapter 843, Insurance Code, if |
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subject to that chapter, to provide health care in that region and |
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that is: |
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(1) wholly owned and operated by a hospital district |
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in that region; |
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(2) created by a nonprofit corporation that: |
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(A) has a contract, agreement, or other |
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arrangement with a hospital district in that region or with a |
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municipality in that region that owns a hospital licensed under |
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Chapter 241, Health and Safety Code, and has an obligation to |
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provide health care to indigent patients; and |
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(B) under the contract, agreement, or other |
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arrangement, assumes the obligation to provide health care to |
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indigent patients and leases, manages, or operates a hospital |
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facility owned by the hospital district or municipality; [or] |
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(3) created by a nonprofit corporation that has a |
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contract, agreement, or other arrangement with a hospital district |
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in that region under which the nonprofit corporation acts as an |
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agent of the district and assumes the district's obligation to |
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arrange for services under the Medicaid expansion for children as |
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authorized by Chapter 444, Acts of the 74th Legislature, Regular |
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Session, 1995; or |
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(4) if the commission does not have an existing |
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contract with a managed care organization in a health care service |
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region under Subdivision (1), (2), or (3) on September 1, 2021, |
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wholly owned by a provider-sponsored health organization that owns |
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and operates: |
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(A) two trauma facilities designated as level I |
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trauma facilities by the Department of State Health Services under |
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Section 773.115, Health and Safety Code, that are located in |
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different trauma service areas; and |
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(B) a hospital licensed under Chapter 241, Health |
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and Safety Code, that is located in the health care service region. |
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SECTION 2. The changes in law made by this Act apply only to |
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the award of a contract by the Health and Human Services Commission |
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on or after the effective date of this Act. |
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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 immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2021. |